Activase (alteplase) News

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|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] AN UNUSUAL CAUSE OF PLEURAL EMPYEMA () - Oct 12, 2020 - Abstract #CHEST2020CHEST_1765;
For optimal source control a 14 Fr chest tube and a percutaneous hepatic drain were placed, along with administration of alteplase and dornase... Liver abscess leading to empyema through trans-diaphragmatic spread is an infrequent cause of empyema, and should be considered in patients who have undergone recent liver surgery.

|||||||||| enoxaparin sodium / Generic mfg.
[VIRTUAL] A CASE OF PHLEGMASIA CERULEA DOLENS AND MAY-THURNER SYNDROME IN A YOUNG MALE WITH TRIPLE-POSITIVE ANTIPHOSPHOLIPID ANTIBODY SYNDROME () - Oct 12, 2020 - Abstract #CHEST2020CHEST_1548;
He received catheter-directed thrombolysis for PCD with alteplase and heparin infusion...After stent placement, patient received bridging to warfarin with enoxaparin and was discharged home two days later... We reported a case, 37 year old male with phlegmasia cerulea dolens and May-Thurner syndrome resulting from triple-positive antiphospholipid antibody syndrome.

|||||||||| enoxaparin sodium / Generic mfg.
[VIRTUAL] A CASE OF COVID-19-ASSOCIATED ACUTE LIMB ISCHEMIA () - Oct 12, 2020 - Abstract #CHEST2020CHEST_1206;
Clinicians should assess therapeutic anticoagulation and lab values such as D-dimer may help with the decision. Given the infectivity of COVID19, precautions must be made to limit unnecessary exposure where possible, as in this case where peripheral intervention was only performed once the patient had completed her treatment course.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] ECMO AS A BRIDGE FOR THROMBECTOMY IN THE SETTING OF MASSIVE PULMONARY EMBOLISM () - Oct 12, 2020 - Abstract #CHEST2020CHEST_969;
mPE can be a catastrophic medical condition even in a previously healthy and young population. In our case ECMO was successfully used as a bridge to mechanical thrombectomy.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] TO LYSE OR NOT TO LYSE: MECHANICAL AORTIC VALVE THROMBOSIS () - Oct 12, 2020 - Abstract #CHEST2020CHEST_898;
Prosthetic valve thrombosis is a rare yet serious complication after a valve replacement. Due to this, it requires swift diagnosis and in patients that are not optimal surgical candidates, fibrinolysis remains a viable, yet not well-studied, option.

|||||||||| ticagrelor / Generic mfg.
[VIRTUAL] ANGIOEDEMA SECONDARY TO TICAGRELOR: A RARE COMPLICATION () - Oct 12, 2020 - Abstract #CHEST2020CHEST_871;
P2Y12 inhibitors have bleeding as well as non-bleeding complications. We present a rare case of angioedema secondary to brilinta use with possible contribution from lisinopril.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Clotting of Hemodialysis Catheters in Patients with Renal Failure with COVID-19 (On-Demand) - Oct 11, 2020 - Abstract #KIDNEYWEEK2020KIDNEY_WEEK_1513;
Increased clotting was noted as a barrier to providing optimal HD therapy. For this and other reasons, we initiated an urgent start acute peritoneal dialysis program to mitigate the challenges in delivering HD to COVID-19 patients.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: The Second Strategic Reperfusion Early After Myocardial Infarction (STREAM-2) study optimizing pharmacoinvasive reperfusion strategy in older ST-elevation myocardial infarction patients. (Pubmed Central) - Oct 9, 2020
For this and other reasons, we initiated an urgent start acute peritoneal dialysis program to mitigate the challenges in delivering HD to COVID-19 patients. The study will provide new insights aimed at establishing an effective and safer pharmaco-invasive treatment for the growing population of older STEMI patients who cannot undergo timely pPCI.

|||||||||| Soliris (eculizumab) / Alexion Pharma, Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] Internal Crowdsourcing To Achieve Cost-Savings During A Pandemic () - Oct 8, 2020 - Abstract #ASHP2020ASHP_433;
Empowering front-line staff with the tools to assess impact and feasibility, implement ideas, and track results is key to success. Future direction for this project includes increasing pharmacy technician participation through education on high-cost drug utilization and stepwise implementation through “Plan-Do-Check-Act” (PDCA) cycles with project owners.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Infections causing stroke or stroke-like syndromes. (Pubmed Central) - Oct 8, 2020
Future direction for this project includes increasing pharmacy technician participation through education on high-cost drug utilization and stepwise implementation through “Plan-Do-Check-Act” (PDCA) cycles with project owners. Stroke or stroke-like syndrome of infectious origin can be observed in an important proportion of case presenting with sensory-motor deficit of unknown origin; their accurate diagnosis has a considerable impact in terms of treatment choices and outcome.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute ischemic stroke: improving access to intravenous tissue plasminogen activator. (Pubmed Central) - Oct 8, 2020
Specific considerations based on region, population, and healthcare resources should be considered for each strategy. Neuroimaging approaches to identify alteplase-eligible patients beyond the 4.5-hour treatment window are a recent development in acute stroke care that holds promise for increasing alteplase treatment rates.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Patient LEVEL Cost Analysis of Mechanical Thrombectomy and Intravenous Thrombolysis for the Treatment of ACUTE Ischemic Stroke Patients in Hungary () - Oct 3, 2020 - Abstract #ISPOREU2020ISPOR-EU_743;
OBJECTIVES : Intravenous thrombolysis (IVT) with alteplase and mechanical thrombectomy (MT) are widely used in Hungary in the management of acute ischemic stroke (AIS), however, there is a lack of data on the actual cost of these procedures...Due to the increasing number of patients treated with MT, it is important to assess the cost-effectiveness of this technique in the local population to evaluate value for money. Our data and cost collecting methods make further cost-effectiveness studies possible.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Cost-Effectiveness of MRI-Guided Thrombolysis for Stroke Patients with Unknown Time of Onset () - Oct 3, 2020 - Abstract #ISPOREU2020ISPOR-EU_628;
Univariate sensitivity analysis and probabilistic sensitivity analysis (Monet Carlo Simulation) was conducted to test robustness, both indicating robustness of our results across a wide range of parameters. CONCLUSIONS MRI-guided thrombolysis with intravenous alteplase compared to placebo is cost-effective in ischemic stroke patients with unknown time of onset.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Cost-Effectiveness of Alteplase to TREAT ACUTE Ischemic Stroke within 4.5 Hours after Onset in the Brazilian Unified Health System Perspective. () - Oct 3, 2020 - Abstract #ISPOREU2020ISPOR-EU_103;
In PSA, the 95% confidence interval were R$ 11,395.00 to R$ 30,837.47/LYG and R$ 15,450.79 to R$ 16,983.76/QALY, with 70.7% and 93.1% being under a willingness-to-pay threshold of R$ 31,833.50 (2019 gross domestic product per capita of Brazil). CONCLUSIONS : Treatment of acute ischemic stroke with alteplase until 4.5 hours from onset is cost-effective in the perspective of the Brazilian public health system.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Blood Pressure Management Following Acute Ischemic Stroke: A Review of Primary Literature. (Pubmed Central) - Oct 3, 2020
Despite these guidelines, there is limited evidence to support specific blood pressure targets, and variability in clinical practice is common. The purpose of this review was to discuss blood pressure management in adult patients with acute ischemic stroke, focusing on appropriate targets in the setting of alteplase administration, mechanical thrombectomy, and hemorrhagic transformation.

|||||||||| vancomycin / Generic mfg., Cubicin (daptomycin) / Merck (MSD), Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Review, Journal: Use of Intraventricular Medications in Critically Ill Patients: A Systematic Review. (Pubmed Central) - Oct 3, 2020
There is a need for increased research on the topic; however, several practical barriers decrease the likelihood of a large, placebo-controlled, prospective study for most indications. Providers should consider implementing protocols to maximize safety of IVT medication delivery to ensure optimal patient outcomes.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Can clinical audits be enhanced by pathway simulation and machine learning? An example from the acute stroke pathway. (Pubmed Central) - Oct 2, 2020
These models, based on standard clinical audit data, may be applied at scale while providing results at individual hospital level. The models facilitate understanding of variation and levers for improvement in stroke pathways, and help set realistic targets tailored to local populations.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: How Do Physicians Approach Intravenous Alteplase Treatment in Patients with Acute Ischemic Stroke Who Are Eligible for Intravenous Alteplase and Endovascular Therapy? Insights from UNMASK-EVT. (Pubmed Central) - Oct 1, 2020
The models facilitate understanding of variation and levers for improvement in stroke pathways, and help set realistic targets tailored to local populations. In patients eligible for endovascular therapy and intravenous alteplase, we observed a slightly lower decision rate in favor of intravenous alteplase under assumed ideal conditions compared with the decision rate under current local resources.

|||||||||| warfarin / Generic mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Acute peripheral pulmonary embolism attributed to autoimmune haemolytic anaemia: a case report. (Pubmed Central) - Oct 1, 2020
PE attributed to AIHA is characterized by subsegment and distal pulmonary artery embolism which is easily neglected but always life-threatening. This case also highlights the PE as a secondary diagnosis should be evaluated comprehensively in order to identify the underlying pathogenesis.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Journal: Safety of Therapeutic Anticoagulation with Low-Molecular-Weight Heparin or Unfractionated Heparin Infusion during Catheter-Directed Thrombolysis for Acute Pulmonary Embolism. (Pubmed Central) - Sep 30, 2020
Therapeutic anticoagulation during CDT for PE appears to be safe. The current study did not find a significant difference between LMWH and heparin infusion with respect to hemorrhagic and general complication rates.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Review, Journal: Priority Nursing Interventions Caring for the Stroke Patient. (Pubmed Central) - Sep 30, 2020
Prioritizing nursing intervention and intensive care monitoring can improve patient outcomes and reduce disability. A collaborative interdisciplinary team approach best facilitates the ICU care of an acute stroke patient.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] TREATMENT EFFECT AND SAFETY OF THROMBOLYSIS IN PATIENTS WITH WHITE MATTER HYPERINTENSITIES OF PRESUMED VASCULAR ORIGIN IN THE WAKE-UP TRIAL (Hall C) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_940;
P3
WMH volume was quantified semi-automatically on FLAIR images of patients randomized to either alteplase or placebo...Conclusions WMH volume is not associated with treatment effect of thrombolysis and does not pose a safety risk of thrombolysis in ischemic stroke patients. Trial Registration Number NCT01525290

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] EXPANDED TREATMENT IN CEREBRAL INFARCTION (ETICI) SCORE AND TREATMENT EFFECT OF NERINETIDE IN THE ESCAPE-NA1 TRIAL (Hall H) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_659;
P3
For this subgroup analysis, the primary analysis as well as exploratory analyses were conducted to elucidate the influence of the degree of reperfusion on functional independence, mortality, and infarction volumes. Results Will-be-presented-at-ESOC Conclusions Will-be-presented-at-ESOC Trial Registration Number NCT02930018

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] TREATMENT EFFECT OF NERINETIDE IN PATIENTS WITH AND WITHOUT INTRAVENOUS ALTEPLASE TREATMENT IN THE ESCAPE-NA1 TRIAL (Hall H) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_656;
P3
Logistic regression including a multiplicative interaction term was performed to determine potential treatment effect modification by intravenous alteplase. Results Will be presented at ESOC Conclusions Will be presented at ESOC Trial Registration Number NCT02930018

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] INFLUENCE OF STUDY DRUG ADMINISTRATION TO REPERFUSION TIME ON TREATMENT EFFECT IN THE ESCAPE-NA1 TRIAL (Hall H) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_655;
P3
Background And Aims Intravenous alteplase is currently the only available medical treatment option for acute ischemic stroke, and is often administered concurrently with endovascular treatment (EVT)...Similar principles apply to NA1 (Nerinetide), an intravenous neuroprotectant that targets protein-protein interactions in the brain parenchyma to perturb neurotoxic signaling...For this subgroup analysis of the trial, multivariable logistic regression analysis with adjustment for clinical and imaging baseline parameters was performed to predict the influence of time from study drug administration to EVT on good functional outcome, defined as modified Rankin Score (mRS) 0-2, excellent functional outcome (mRS0-1), and final infarct-volume (determined on 24 hr CT or diffusion-weighted MRI). Results Will-be-presented-at-ESOC Conclusions Will-be-presented-at-ESOC Trial Registration Number NCT02930018

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] ASIANS VERSUS NON-ASIAN, DIFFERENCES IN CHARACTERISTIC, MANAGEMENT AND OUTCOMES FOR TPA-TREATED ACUTE ISCHEMIC STROKE PATIENTS IN THE ENCHANTED TRIAL (Hall F) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_588;
P3
Methods ENCHANTED was a partial-factorial trial in thrombolysis-eligible AIS patients randomly assigned to: (i) low-dose (0.6mg/kg) or standard-dose (0.9mg/kg) alteplase and; (ii) intensive (target systolic blood pressure [SBP] 130-140 mmHg) or guideline-recommended <180 mmHg) BP management...Results Among 4551 patients (mean age 66.6 years, 37.8% female, 65.5% Asian) Asian patients were younger and less likely to have comorbidity (atrial fibrillation and hypercholesterolemia) and concomitant antihypertensive, warfarin, aspirin and statin therapy compared to non-Asians...Trial Registration Number ClinicalTrials. ID: NCT01422616

|||||||||| Integrilin (eptifibatide) / Takeda, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] “Thrombolytic Cocktails” – Alteplase, Argatroban, Eptifibatide And Beyond (Hall E) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_570;

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] REAL WORLD EXPERIENCE OF MECHANICAL THROMBECTOMY IN ENGLAND, WALES AND NORTHERN IRELAND: RESULTS FROM NATIONAL STROKE REGISTRY AND COMPARISON WITH THE HERMES META-ANALYSIS (Hall D) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_527;
Conclusions Despite some differences in casemix, alteplase use and reperfusion, outcomes observed following MT in England, Wales and Northern Ireland are comparable to those reported in the HERMES meta-analysis. Trial Registration Number Not applicable

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] THROMBOLYSIS IN UNKNOWN ONSET STROKE GUIDED BY ADVANCED IMAGING – INDIVIDUAL PATIENT DATA META-ANALYSIS FROM WAKE-UP, THAWS, EXTEND, ECASS-4, AND MR WITNESS (Hall A) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_442;
P2a, P3
Background And Aims Intravenous alteplase is approved for acute stroke treatment within 4.5 hours of known symptom onset...Conclusions Meta-analysis of individual patient data from clinical trials will provide more robust evidence on efficacy and safety of intravenous thrombolysis in patients with stroke of unknown onset selected by advanced brain imaging. Trial Registration Number NCT01525290, NCT00887328, NCT02002325, ISRCTN 71616222, NCT01282242

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] ASSOCIATION BETWEEN PRE-TREATMENT PERFUSION PROFILE AND CEREBRAL EDEMA AFTER REPERFUSION THERAPIES (Hall A) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_416;
Methods In post-hoc pooled analysis of the EXTEND-IA TNK part 1 and part 2 multicentre RCTs of tenecteplase/alteplase and endovascular thrombectomy for anterior circulation large vessel occlusion (LVO), we tested associations between core and mismatch volumes on admission CT-Perfusion and cerebral edema, defined as >1mm midline shift(MLS) on 24h follow-up CT or MRI...Our data provide further evidence that reperfusion reduces edema by arresting at-risk tissue from progressing to infarction. Trial Registration Number Not applicable

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] FAULTY ESTIMATES OF PATIENTS’ BODY-WEIGHT AFFECT DOSE OF INTRAVENOUS ALTEPLASE WITHOUT AFFECTING THE OUTCOME (Virtual E-Poster Area) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_324;

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] EFFECTIVENESS OF STANDARD- VERSUS LOW-DOSE ALTEPLASE FOR ACUTE ISCHEMIC STROKE WITHIN 3 TO 4.5 HOURS (Virtual E-Poster Area) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_319;

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Tenecteplase VS. Alteplase (Hall I) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_257;

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] TREATMENT EFFECT OF ALTEPLASE VS TENECTEPLASE IN SLOW AND FAST PROGRESSORS (Hall H) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_224;
P2
The ongoing ATTEST-2 and TASTE trials present an opportunity to further examine these relationships. Trial Registration Number A Randomized Trial of Tenecteplase versus Alteplase for Acute Ischemic Stroke - ACTRN12608000466347 Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study - NCT01472926

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] ALTEPLASE ATTENUATES PROGRESSIVE LOSS OF STRUCTURAL CONNECTIVITY AFTER ANTERIOR-CIRCULATION STROKE IN THE WAKE-UP TRIAL (Hall H) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_221;
When evaluating the benefit of reperfusion therapy, structural connectivity may provide a more specific neuroimaging marker of treatment response than lesion volume. Trial Registration Number Not applicable

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] A RANDOMIZED TRIAL OF DIRECT ENDOVASCULAR THROMBECTOMY VERSUS THROMBECTOMY PRECEDED BY INTRAVENOUS ALTEPLASE IN ACUTE ISCHEMIC STROKE (Hall A) - Sep 30, 2020 - Abstract #ESOWSO2020ESO_WSO_34;

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Clinical Characteristics and Outcome of Patients With Hemorrhagic Transformation After Intravenous Thrombolysis in the WAKE-UP Trial. (Pubmed Central) - Sep 30, 2020
In contrast to HI, PH is associated with worse functional outcome. The impact of HT after MRI-guided intravenous alteplase for unknown onset stroke on clinical outcome is similar as in the trials of stroke thrombolysis within a known early time-window.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Probing the Effective Treatment Thresholds for Alteplase in Acute Ischemic Stroke With Regression Discontinuity Designs. (Pubmed Central) - Sep 30, 2020
We did not find evidence of a discontinuity in clinical outcome at any treatment threshold attributable to alteplase. Potential reasons for failing to find an effect include violation of some RDD assumptions in clinical care, large sample sizes required, or already-well-chosen treatment threshold.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Thromboelastography to Detect Hypercoagulability and Reduced Fibrinolysis in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome Patients. (Pubmed Central) - Sep 30, 2020
Measurement of thromboelastography (n = 10) and thrombolysis with alteplase (n = 4)...In coronavirus disease 2019 patients with acute respiratory distress syndrome in whom thromboelastography was performed, hypercoagulability and impaired fibrinolysis were observed. In the context of autopsy studies demonstrating pulmonary microvascular thromboses in coronavirus disease 2019 patients, noninvasive detection of hypercoagulability and deficient fibrinolysis in coronavirus disease 2019 acute respiratory distress syndrome using thromboelastography could improve understanding and management of coronavirus disease 2019.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical: We are pleased to announce the ACT trial Twitter account! We are a registry-based randomized controlled trial comparing alteplase vs. tenecteplase in acute ischemic stroke. @shelaghcoutts @neuroccm @AleksandraPik11 @bijoymenon @mihill68 @DCNSNeuro (Twitter) - Sep 29, 2020

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Submacular haemorrhage: 10 cases, one surgical technique, time-depending results (Abstract Channel) - Sep 28, 2020 - Abstract #EURETINA2020EURETINA_1544;
The analyzed technique has shown good results in a bad prognosis disease. There were statistical differences between Group 1 and Group 2, in addition clinically improvement to 0 LogMAR vision in two cases in Group 1 shows that prompt surgery is determinant to real functional improvements.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Surgical outcomes of subretinal injection of tissue plasminogen activator in patients with ruptured retinal arterial macroaneurysm versus polypoidal choroidal vasculature (Abstract Channel) - Sep 28, 2020 - Abstract #EURETINA2020EURETINA_975;
However, a significant BCVA improvement was obtained only in the RAM cases. The relatively poor functional outcomes of the PCV cases may be attributable to postoperative complications and pre-existing retinal damage.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Early reperfusion therapy with intravenous alteplase for recovery of vision in acute central retinal artery occlusion (revision): a double-blind randomized placebo-controlled phase II proof-of-concept trial (Abstract Channel) - Sep 28, 2020 - Abstract #EURETINA2020EURETINA_900;
P3
Treatment delays, however, were up to 20h and 24h respectively. Similar to IVT in ischemic stroke, a meta-analysis incl.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute Ischemic Stroke and COVID-19: Experience From a Comprehensive Stroke Center in Midwest US. (Pubmed Central) - Sep 27, 2020
AIS in the setting of COVID-19 is associated with worse outcomes, especially among African-American and Latino populations. Large vessel disease with ESUS was common suggesting an increased risk of coagulopathy and endothelial dysfunction as a potential etiology.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Acute stroke treatment in old age (Pubmed Central) - Sep 26, 2020
Patients over 80 years often do not undergo IVT or MT. Although the German approval for alteplase within the framework of IVT over the age of 80 years suggests a careful and critical review of the indications, its use is generally recommended.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Long-Term Functional Outcome of Telestroke Patients Treated Under Drip-and-Stay Paradigm Compared with Patients Treated in a Comprehensive Stroke Center: A Single Center Experience. (Pubmed Central) - Sep 25, 2020
Although the German approval for alteplase within the framework of IVT over the age of 80 years suggests a careful and critical review of the indications, its use is generally recommended. Our study shows no difference in the long-term functional outcome for patients who received tPA through telestroke consultation and remained at spoke hospitals (drip-and-stay) compared with patients who received tPA at the hub.

|||||||||| Cerebrolysin (porcine brain-derived proteolytic peptide fraction) / Novartis, EVER Pharma, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Current Drug Treatment of Acute Ischemic Stroke: Challenges and Opportunities. (Pubmed Central) - Sep 23, 2020
Recent years have shown clear improvements in the methodology and design of clinical trials, with an increase in overall internal and external validity. A better understanding of study limitations has not hindered, but enhanced their potential to contribute, together with sometimes superior data sources, to health decision making.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
[VIRTUAL] Alteplase, Tenecteplase, A New Plase in Therapy? () - Sep 23, 2020 - Abstract #ASHP2020ASHP_193;
A better understanding of study limitations has not hindered, but enhanced their potential to contribute, together with sometimes superior data sources, to health decision making. Learning Objectives: Identify the role of teneceteplase in the treatment of acute ischemic stroke.

|||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Using Tenecteplase for Acute Ischemic Stroke: What Is the Hold Up? (Pubmed Central) - Sep 23, 2020
When given at 0.25 milligrams per kilogram (mg/kg), tenecteplase may have less bleeding complications than alteplase as well. This narrative review evaluates the literature and addresses the practical issues with regards to the use of tenecteplase versus alteplase for acute ischemic stroke, and it recommends that physicians consider tenecteplase rather than alteplase for thrombolysis of acute ischemic stroke.

|||||||||| Pradaxa (dabigatran etexilate) / Boehringer Ingelheim
Journal: Dabigatran Reversal Before Intravenous Tenecteplase in Acute Ischemic Stroke. (Pubmed Central) - Sep 23, 2020
Conclusions- Our experience suggests intravenous thrombolysis with tenecteplase following dabigatran reversal using idarucizumab may be safe in selected patients with acute ischemic stroke. Further studies are required to more precisely estimate the efficacy and risk of clinically significant hemorrhage.



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