Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe 
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  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Reflection on the Past, Present, and Future of Thrombolytic Therapy for Acute Ischemic Stroke. (Pubmed Central) -  Mar 26, 2022   
    We provide an overview of alteplase, including its earliest trials and how they have shaped the current therapeutic landscape of ischemic stroke treatment, and touch on new frontiers for thrombolytic therapy. We highlight the critical role of thrombolytic therapy in the past, present, and future of ischemic stroke care.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Sustainability of Intravenous Alteplase Administration via Telephone-Based Consult: Data from a US Health System. (Pubmed Central) -  Mar 25, 2022   
    In a large dataset over nearly a decade, assessment for IV tPA administration using telephone assessment along with imaging review and emergency department standardization resulted in similar safety and outcomes as in the presence of on-site stroke/neurology expertise. Future studies are needed to confirm these findings.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Review, Journal:  Acute Treatment of Ischemic Stroke. (Pubmed Central) -  Mar 24, 2022   
    Current controversies and ongoing trials within endovascular treatment are also detailed. Case presentations are included to provide clinical context and the application of data to practice.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    PHARMACODYNAMIC EVALUATION OF VARYING ALTEPLASE DOSAGES FOR THE TREATMENT OF PULMONARY EMBOLISM ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1912;    
    CD had the least effect on A2A and TEG LY30, however D-Dimer increases and fibrinogen decreases were similar. Our findings highlight the need for PK/PD evaluations of new thrombolytic strategies that can better retain benefits and minimize risk.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    OUTCOMES OF PATIENTS WITH HIGH-RISK SUBMASSIVE PULMONARY EMBOLISM RECEIVING FIBRINOLYTICS ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1883;    
    Our findings highlight the need for PK/PD evaluations of new thrombolytic strategies that can better retain benefits and minimize risk. In patients receiving alteplase, fibrinolytics did not decrease the risk of hemodynamic decompensation in patients with a high-risk submassive PE compared to anticoagulation alone.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    NEUROINTERVENTIONAL RADIOLOGY OUTCOMES IN PATIENTS WITH ACUTE ISCHEMIC STROKE ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1793;    
    There also was no statistical difference in sICH. In patients requiring salvage therapy IA therapies may be an option however further research is required to determine the safety of such intervention.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    MAJOR BLEEDING OF TENECTEPLASE VERSUS ALTEPLASE IN ACUTE ISCHEMIC STROKE ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1781;    
    In patients requiring salvage therapy IA therapies may be an option however further research is required to determine the safety of such intervention. Tenecteplase had similar rates of major bleeding versus alteplase in the treatment of acute ischemic stroke.
  • ||||||||||  Integrilin (eptifibatide) / Takeda
    SAFETY OF REDUCED-DOSE EPTIFIBATIDE IN ACUTE ISCHEMIC STROKE PATIENTS ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1720;    
    These results suggest the use of eptifibatide in AIS may be safe, however, the study is limited by the small patient population. More research is required to determine significance in adverse effects and of eptifibatide in this patient population.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    STROKE AND PULMONARY EMBOLISM AS THE FIRST PRESENTATION OF COVID-19 INFECTION ([VIRTUAL]) -  Mar 23, 2022 - Abstract #SCCM2022SCCM_1135;    
    CT head ruled out bleeding and CT Angiogram (CTA) of the head did not show Intracranial Large Vessel Occlusion (LVO), so he was not a candidate for Alteplase or for Mechanical Thrombectomy...The patient did not exhibit any respiratory symptoms throughout his admission and was discharged to a rehabilitation facility on Apixaban for anticoagulation...Our patient did not have any risk factors such as Atrial Fibrillation or a hypercoagulable state. The patient’s thrombotic sequelae happened in the absence of respiratory symptoms and thus illustrates the need for physicians to have a low threshold for Neuroimaging in COVID-19 patients with Stroke-like symptoms.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Trial completion date, Trial primary completion date:  TRISTARDS: A Study to Test Whether Different Doses of Alteplase Help People With Severe Breathing Problems Because of COVID-19 (clinicaltrials.gov) -  Mar 23, 2022   
    P2b/3,  N=320, Recruiting, 
    The patient’s thrombotic sequelae happened in the absence of respiratory symptoms and thus illustrates the need for physicians to have a low threshold for Neuroimaging in COVID-19 patients with Stroke-like symptoms. Trial completion date: Aug 2022 --> Feb 2023 | Trial primary completion date: Jun 2022 --> Dec 2022
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Early neurological deterioration after intravenous thrombolysis of anterior vs posterior circulation stroke: a secondary analysis of INTRECIS. (Pubmed Central) -  Mar 17, 2022   
    P=N/A
    We screened patients receiving intravenous 0.9 mg/kg alteplase within 4.5 h in the INTRECIS cohort...END was associated with worse outcome on 90-day mRS in ACS and PCS (adjusted p < 0.001). Based on a prospective nationwide cohort, we provided first report for similar incidence, but different risk factors of post-thrombolytic END in ACS vs PCS patients.Trial Registration-URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02854592.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Clinical, Review, Journal:  Cardio-cerebral infarction in left MCA strokes: a case series and literature review. (Pubmed Central) -  Mar 16, 2022   
    Fibrinolysis and mechanical thrombectomy (MT) were discussed in all cases, but only one patient received alteplase (0.9 mg/kg) and none underwent MT...CCI poses a clinical challenge for physicians including (1) optimal strategies to enable swift mechanical reperfusion to both the brain and myocardium; (2) difference in dosage of thrombolytics for AIS versus AMI; (3) risk of symptomatic intracerebral hemorrhage following administration of anticoagulation and/or antiplatelet therapy; and (4) caution with use of thrombolytics in the setting of acute STEMI due to the risk of myocardial rupture. In the absence of high quality evidence and clinical guidelines, treatment of CCI is highly individualized.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Our Efforts for Ideal Stroke Prevention and Treatment in Japan. (Pubmed Central) -  Mar 16, 2022   
    In the present short review for the Sherman Award, Dr Yamaguchi introduces studies at the National Cerebral and Cardiovascular Center, Osaka, which included development of intravenous thrombolysis using low-dose alteplase that was officially approved in Japan, long-term dual antiplatelet therapy using cilostazol together with aspirin or clopidogrel, and others. He also discusses efforts to ensure the passage of the "Stroke and Cardiovascular Disease Control Act," the aims of which are better primary prevention, better acute treatment, rehabilitation, and secondary prevention of stroke for people living in Japan.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Retrospective data, Journal:  Acute telestroke evaluations during the COVID-19 pandemic. (Pubmed Central) -  Mar 16, 2022   
    Among telestroke requests, characteristics of age, gender, race/ethnicity, National Institutes of Health Stroke Scale (NIHSS), primary diagnosis of AIS or transient ischemic attack (TIA), and number of patients receiving intravenous alteplase (IV-rtPA) and endovascular therapy (ET) were recorded...Higher NIHSS and severity in all telestroke evaluations reflect neurological manifestations of AIS and mimics, possibly influenced by COVID-19. The younger age of those with suspected AIS or TIA reflects thrombotic complications in atypical stroke populations.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Catheter-directed thrombolysis in acute critical limb ischemia (Pubmed Central) -  Mar 15, 2022   
    The median alteplase dose was 5 mg (IQR: 5), the median continuous dose was 2 mg/h (IQR: 0.8)...Additional intravenous heparin given during thrombolysis did not affect reocclusion rate and amputation-free survival...Orv Hetil. 2022; 163(11): 424-430.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
    TWIST (TENECTEPLASE IN WAKE-UP ISCHAEMIC STROKE TRIAL) (Amphithéâtre) -  Mar 12, 2022 - Abstract #ESOC2022ESOC_1635;    
    We examined the efficacy and safety of treatment with tenecteplase in 578 patients selected by non-contrast CT. Further conclusions will be presented at the conference.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    REVERSIBILITY OF DIFFUSION WEIGHTED IMAGING LESIONS IN ISCHEMIC STROKE PATIENTS IN THE WAKE-UP TRIAL (Bellecour 1-3) -  Mar 12, 2022 - Abstract #ESOC2022ESOC_1278;    
    MIS+alteplase in patients with large ICH and IVH was associated with reduction in IVH volume, but this did not translate into a significant benefit in mortality or functional outcomes. DWIR was present in a large proportion of randomized patients in the WAKE-UP trial and was more often seen after thrombolysis, although absolute reversible volumes were small.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    ALTEPLASE COMPARED TO TENECTEPLASE (ACT) RANDOMIZED CONTROLLED TRIAL (Amphithéâtre) -  Mar 12, 2022 - Abstract #ESOC2022ESOC_1087;    
    Future stroke trials should assess a lower dose of tenecteplase versus alteplase in patients with moderate or severe stroke.EudraCT No 2018-003090-95. Results from the AcT trial will provide real world evidence regarding effectiveness of intravenous tenecteplase vs. alteplase in patients with acute ischemic stroke eligible for intravenous thrombolysis.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    EFFECT OF INTRAVENOUS ALTEPLASE ON PATIENT-REPORTED HEALTH-RELATED QUALITY OF LIFE AFTER STROKE IN THE WAKE-UP TRIAL (Forum 1) -  Mar 12, 2022 - Abstract #ESOC2022ESOC_1027;    
    Results from the AcT trial will provide real world evidence regarding effectiveness of intravenous tenecteplase vs. alteplase in patients with acute ischemic stroke eligible for intravenous thrombolysis. Assessment of patient-reported outcome measures reveals potential beneficial effects of intravenous alteplase on HRQoL beyond improvement of functional outcome.