- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
[VIRTUAL] MULTIPLE ARTERIAL EMBOLI SECONDARY TO LEFT VENTRICULAR THROMBUS (eAbstract site) - Feb 17, 2021 - Abstract #ACC2021ACC_1844;
After twelve hours of alteplase infusion, there was an abrupt onset of bilateral sharp and constant flank pain... The report describes the clinical manifestation and successful treatment of multiple arterial emboli secondary to left ventricular thrombus.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Tenecteplase Thrombolysis for Acute Ischemic Stroke. (Pubmed Central) - Feb 17, 2021
Current clinical practice guidelines for stroke include intravenous tenecteplase at either dose as a second-tier option, with the 0.25 mg/kg dose recommended for large vessel occlusions, based on a phase 2 trial that demonstrated superior recanalization and improved 3-month outcome relative to alteplase. Ongoing randomized phase 3 trials may better define the comparative risks and benefits of tenecteplase and alteplase for stroke thrombolysis and answer questions of tenecteplase efficacy in the >4.5-hour time window, in wake-up stroke, and in combination with endovascular thrombectomy.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Effectiveness of Delayed Intrapleural Alteplase Instillation for Infected Residual Traumatic Hemothorax. Case Report. (Pubmed Central) - Feb 17, 2021
Recent studies describe the use of alteplase in these patients but mostly in the first days after the trauma, when it becomes clear that the first chest tube is not being effective. We report a case of residual traumatic hemothorax that could not be evacuated after multiple chest tubes placements and was finally cleared after instillation of alteplase late in the course of the disease.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Enhancing the Informed Consent Process Using Shared Decision Making and Consent Refusal Data from the CLEAR III Trial. (Pubmed Central) - Feb 9, 2021
P3
We report a case of residual traumatic hemothorax that could not be evacuated after multiple chest tubes placements and was finally cleared after instillation of alteplase late in the course of the disease. The informed consent process for prospective randomized trials may be enhanced by studying and refining best practices based on trial-specific plans and patient concerns particular to a study.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: ARAMIS: Antiplatelet vs R-tPA for Acute Mild Ischemic Stroke (clinicaltrials.gov) - Feb 3, 2021
P4, N=760, Recruiting,
Alteplase 1 mg is as effective as 2 mg in restoring HDC malfunction and may result in cost reduction in haemodialysis units. Trial completion date: Sep 2022 --> Dec 2022 | Trial primary completion date: Apr 2022 --> Dec 2022
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Observational data, Retrospective data, Journal: Impact of COVID-19 pandemic on acute stroke care: facing an epidemiological paradox with a paradigm shift. (Pubmed Central) - Feb 3, 2021
The "hospital avoidance" of stroke patients during the "stay-at-home" appeals needs to be considered for future public health campaigns. A prompt reorganization of the stroke network can guarantee optimal performances at times of crisis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Preclinical, Journal: Assessment of recombinant tissue plasminogen activator (rtPA) toxicity in cultured neural cells and subsequent treatment with poly-arginine peptide R18D. (Pubmed Central) - Jan 30, 2021
In summary, the findings show that rtPA can be toxic to neural cells and that OGD exacerbates toxicity, while R18D has the capacity to reduce rtPA neural cellular toxicity and reduce MMP-9 activation in astrocytes and bEnd.3. Poly-arginine-18 peptides, which are being developed as neuroprotective therapeutics for ischaemic stroke, therefore have the additional potential of reducing cytotoxic effects associated with rtPA thrombolysis in the treatment of ischaemic stroke.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Tissue Plasminogen Activator-Induced Angioedema Involving a Posterior Cerebral Artery Infarct: A Case Presentation. (Pubmed Central) - Jan 29, 2021
CASE REPORT We describe an 84-year-old woman with a history of hypertension managed with lisinopril who presented with an acute onset of right-sided hemiparesis, slurred speech, and right-sided hemianopsia...Intravenous alteplase was administered and within 30 min our patient developed severe orolingual edema requiring emergent intubation...This phenomenon is usually self-limited and treatment is supportive, although evidence supports the use of antihistamines, steroids, epinephrine, and complement inhibitors. Due to the severity of angioedema and the potential progression to airway compromise, it is crucial to closely monitor patients receiving tissue plasminogen activator.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Who may benefit from lower dosages of intravenous tissue plasminogen activator? Results from a cluster data analysis. (Pubmed Central) - Jan 27, 2021
P=N/A
Altogether, these data suggested that procyanidins exerted a potential neuroprotective effect may by inhibit the TLR4-p38-NF-κB-NLRP3signaling pathway in the brain in MCAO/R rats. Our analysis demonstrated that in patients who had moderate stroke, lower doses of alteplase are associated with significant sICH reduction and non-inferior performance in efficacy, compared with those in the standard dose group.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Who will benefit more from low-dose alteplase in acute ischemic stroke? (Pubmed Central) - Jan 26, 2021
Our analysis demonstrated that in patients who had moderate stroke, lower doses of alteplase are associated with significant sICH reduction and non-inferior performance in efficacy, compared with those in the standard dose group. Use of low-dose alteplase may be preferable in acute ischemic stroke patients with a combination of favorable characteristics, including younger age, lower systolic blood pressure, mild neurological impairment, and no atrial fibrillation, diabetes mellitus, or premorbid symptoms.
- |||||||||| ticagrelor / Generic mfg.
Clinical, Review, Journal: Stroke Thrombolysis in Patients Taking Ticagrelor -Two Successful Cases and a Review of the Literature. (Pubmed Central) - Jan 26, 2021
Despite prior reports of hemorrhagic complications with use of IV alteplase in setting of pre-treatment with ticagrelor, we report the safe use of intravenous thrombolysis in two cases presenting with acute ischemic stroke. Until safety is established in large studies, decision for thrombolysis should be made on case-by-case basis.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Retrospective data, Journal: Impact of COVID-19 on Outcomes in Ischemic Stroke Patients in the United States. (Pubmed Central) - Jan 14, 2021
The use of antiplatelet agents and heparin for stroke interventions following IV alteplase appears to be safe without significant increased risk of hemorrhagic complications in this group of patients when compared to control data and randomized controlled trials. Ischemic stroke patients with COVID-19 are more likely to be male, younger, and Black or Hispanic, with significant increases in morbidity and mortality compared to both ischemic stroke controls from 2019 and to patients with ischemic stroke and pneumonia.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Effect of coronary flow on intracoronary alteplase: a prespecified analysis from a randomised trial. (Pubmed Central) - Jan 14, 2021
P2
This study will provide an evidence-based basis for the clinical efficacy of alteplase for treating AIS by thrombolytic therapy at different time windows. In patients with impaired culprit artery flow (<TIMI 3) after initial balloon angioplasty/thrombus aspiration, intracoronary alteplase was associated with increased presence of microvascular obstruction and myocardial haemorrhage.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Reducing Central Line-Associated Blood Stream Infections on a Blood and Marrow Transplant Unit () - Jan 9, 2021 - Abstract #TCTASTCTCIBMTR2021TCT_ASTCT_CIBMTR_2927;
Additionally, alteplase orders went from 143 during the time period of January 2019 to June 2019 to 76 during the time frame of January 2020 to June 2020. Discussion & Implications This change in practice has demonstrated the delivery of improved quality of care, a decrease in CLABSIs and a decrease in alteplase orders.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Reducing Central Line-Associated Blood Stream Infections on a Blood and Marrow Transplant Unit () - Jan 9, 2021 - Abstract #TCTASTCTCIBMTR2021TCT_ASTCT_CIBMTR_2926;
Additionally, alteplase orders went from 143 during the time period of January 2019 to June 2019 to 76 during the time frame of January 2020 to June 2020. Discussion & Implications This change in practice has demonstrated the delivery of improved quality of care, a decrease in CLABSIs and a decrease in alteplase orders.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Reducing Central Line-Associated Blood Stream Infections on a Blood and Marrow Transplant Unit () - Jan 9, 2021 - Abstract #TCTASTCTCIBMTR2021TCT_ASTCT_CIBMTR_2925;
Additionally, alteplase orders went from 143 during the time period of January 2019 to June 2019 to 76 during the time frame of January 2020 to June 2020. Discussion & Implications This change in practice has demonstrated the delivery of improved quality of care, a decrease in CLABSIs and a decrease in alteplase orders.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Reducing Central Line-Associated Blood Stream Infections on a Blood and Marrow Transplant Unit () - Jan 9, 2021 - Abstract #TCTASTCTCIBMTR2021TCT_ASTCT_CIBMTR_2924;
Additionally, alteplase orders went from 143 during the time period of January 2019 to June 2019 to 76 during the time frame of January 2020 to June 2020. Discussion & Implications This change in practice has demonstrated the delivery of improved quality of care, a decrease in CLABSIs and a decrease in alteplase orders.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Reducing Central Line-Associated Blood Stream Infections on a Blood and Marrow Transplant Unit () - Jan 9, 2021 - Abstract #TCTASTCTCIBMTR2021TCT_ASTCT_CIBMTR_2923;
Additionally, alteplase orders went from 143 during the time period of January 2019 to June 2019 to 76 during the time frame of January 2020 to June 2020. Discussion & Implications This change in practice has demonstrated the delivery of improved quality of care, a decrease in CLABSIs and a decrease in alteplase orders.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Perivascular Hyaluronidase With Alteplase as Treatment for Hyaluronic Acid Thrombosis. (Pubmed Central) - Jan 8, 2021
Perivascular application of hyaluronidase + thrombolytic agent seems to achieve greater reperfusion rates than either one alone. If proven safe in humans, this strategy could make treatment more effective while still being suitable for an outpatient setting.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Rescue therapy with thrombolysis in patients with severe COVID-19-associated acute respiratory distress syndrome. (Pubmed Central) - Jan 7, 2021
We describe seven patients requiring invasive ventilation for COVID-19-associated acute respiratory distress syndrome with pulmonary thromboembolic disease, pulmonary hypertension ± severe right ventricular dysfunction on echocardiography, who were treated with alteplase as fibrinolytic therapy...At seven (1-13) days after thrombolysis, using dual energy computed tomography imaging (n = 3), average relative peripheral lung enhancement increased from 12.6 to 21.6% (p = 0.06). In conclusion, thrombolysis improved PaO/FiO ratio and ventilatory ratio at 24 h as rescue therapy in patients with right ventricular dysfunction due to COVID-19-associated ARDS despite maximum therapy, as part of a multimodal approach, and warrants further study.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Haemorrhagic transformation following ischaemic stroke: A retrospective study. (Pubmed Central) - Jan 6, 2021
A total of 129 (24.5%) patients were taking aspirin prior to their stroke and, of these, 39 (30.2%) developed HT...In conclusion, older age, atrial fibrillation, treatment with oral anticoagulants and antiplatelet medications prior to stroke, low total and LDL cholesterol, and rtPA use, are all associated with HT. Survival was not affected by the presence of HT.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Permeability measures predict haemorrhagic transformation after ischemic stroke. (Pubmed Central) - Jan 6, 2021
In this large multi-centre study, we have validated a highly accurate measure of HT prediction. This measure may be useful in clinical practice to predict haemorrhagic transformation in ischemic stroke patients before receiving alteplase alone.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Stroke in COVID-19: a single-centre initial experience in a hotspot of the pandemic. (Pubmed Central) - Jan 5, 2021
Most of the patients had respiratory symptoms preceding AIS by days to weeks. This could explain certain patients with clinical picture of COVID-19 but negative nasopharyngeal swab tests.
- |||||||||| Radicava (edaravone) / Mitsubishi Tanabe, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Effects of intravenous thrombolysis with alteplase combined with edaravone on cerebral hemodynamics and T lymphocyte level in patients with acute cerebral infarction. (Pubmed Central) - Jan 5, 2021
After the treatment, the neurological function, cerebral hemodynamic indexes, T-lymphocyte level, oxygen free radical scavenging level and oxidative stress indexes of the 2 groups were significantly improved. In addition, the observation group exerted greater beneficial effect in terms of the clinical effect, neurologic function, cerebral hemodynamic index, T lymphocyte level, oxygen free radical scavenging level and oxidative stress index than those of the control group (P < .05).The intravenous thrombolysis with alteplase and edaravone is effective in the treatment of acute cerebral infarction, which also provides better results in terms of improving the clinical efficacy and prognosis of patients and might be an alternative option for clinical practice.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Management of Acute Ischemic Stroke Due to Large-Vessel Occlusion: JACC Focus Seminar. (Pubmed Central) - Dec 30, 2020
The only available 2 treatment options are intravenous alteplase and endovascular therapy (mechanical clot removal), both of which are highly time-dependent...To diagnose and treat patients as fast as possible, the organization of existing systems of care, and particularly pre-hospital transfer systems, have to be changed. Several different transport models are currently in use because the optimal patient transfer paradigm is highly dependent on local geography and hospital efficiency.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: THEIA: A Phase III Randomized, Blind, Double Dummy, Multicenter Study Assessing the Efficacy and Safety of IV THrombolysis (Alteplase) in Patients With acutE Central retInal Artery Occlusion (clinicaltrials.gov) - Dec 29, 2020
P3, N=70, Recruiting,
A similar program could be implemented at other institutions to improve AIS treatment. Trial completion date: Sep 2020 --> Sep 2022 | Trial primary completion date: Jun 2020 --> Sep 2022
|
