- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Tenecteplase versus Alteplase Before Endovascular Therapy in Basilar Artery Occlusion (Hall H) - Dec 21, 2019 - Abstract #ISC2020ISC_716;
Despite shorter needle-to-groin-puncture times, tenecteplase was associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare tenecteplase with alteplase in BAO patients before endovascular thrombectomy are warranted.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Alteplase Now: Benefits of IV tPA in Lacunar Stroke, LVO, pAF, and Minor or Resolving Stroke (Room 151) - Dec 21, 2019 - Abstract #ISC2020ISC_487;
Less than half of patients with mild strokes recanalized with IV alteplase which was associated with longer decision-making times suggesting that more aggressive use of thrombolytics and/or EVT may be viable treatment options in this population. There is no abstract associated with this presentation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
ESCAPE-NA1 Trial (Hall K) - Dec 21, 2019 - Abstract #ISC2020ISC_313;
ESCAPE NA-1 was a pivotal, global phase 3 trial, of a novel peptide treatment for acute ischemic stroke using the paradigm of human ischemia reperfusion. Results are expected to provide an understanding of the initial role of the neuroprotectant nerinetide (NA-1) in AIS.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Hemifacial angioedema following alteplase for acute stroke. (Pubmed Central) - Dec 20, 2019
The optimal TNK dose for ischemic stroke patients appears to be 0.25mg/kg. No abstract available
- |||||||||| Aggrastat (tirofiban) / Correvio, Medicure, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: Tirofiban for Patients Treated With Alteplase (clinicaltrials.gov) - Dec 17, 2019
P2/3, N=220, Recruiting,
No abstract available Trial completion date: Mar 2019 --> Oct 2020 | Trial primary completion date: Dec 2018 --> Jun 2020
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Trial primary completion date: INTRECIS: Intravenous Thrombolysis Registry for Chinese Ischemic Stroke Within 4.5 h Onset (clinicaltrials.gov) - Dec 17, 2019
P=N/A, N=4000, Completed,
Trial completion date: Mar 2019 --> Oct 2020 | Trial primary completion date: Dec 2018 --> Jun 2020 Active, not recruiting --> Completed | Trial primary completion date: Apr 2019 --> Oct 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Single-center experience with thrombolysis in high- and intermediaterisk pulmonary embolism (Industry Exhibition/Foyer) - Dec 17, 2019 - Abstract #GTH2020GTH_150;
The risk of relevant bleedings in patients at intermediate risk receiving thrombolysis was relatively low - possibly because half of them received low-dose alteplase or local lysis. According to current guideline recommendations, the choice for thrombolysis in intermediate-risk PE patients needs to take into account each individual patient's risk for bleeding and PE-related death and these data reinforce this approach.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Retrospective data, Journal: Current Smoking Does Not Modify the Treatment Effect of Intravenous Thrombolysis in Acute Ischemic Stroke Patients-A Post-hoc Analysis of the WAKE-UP Trial. (Pubmed Central) - Dec 12, 2019
P3
We performed a pre-specified post-hoc subgroup analysis of the Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke (WAKE-UP) trial that randomized AIS patients with unknown time of symptom onset who had diffusion-weighted imaging-fluid attenuation inversion recovery (DWI-FLAIR) mismatch to either alteplase or placebo...Clinical Trial registration: Main trial (WAKE-UP): ClinicalTrials.gov, NCT01525290; and EudraCT, 2011-005906-32. Registered 02 February 2012.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Trial initiation date: AcTQuICR: Alteplase Compared to Tenecteplase in Patients With Acute Ischemic Stroke (clinicaltrials.gov) - Dec 12, 2019
P3, N=1600, Recruiting,
Registered 02 February 2012. Not yet recruiting --> Recruiting | Initiation date: Jun 2019 --> Dec 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Minimally Invasive Subacute to Chronic Subdural Hematoma Evacuation with Angled Matchstick Drill and Repurposed Antibiotic Ventriculostomy Catheter Augmented with Alteplase: A Technical Case Report. (Pubmed Central) - Dec 12, 2019
The operative management of subacute subdural hematomas (sSDHs) and chronic subdural hematomas (cSDHs) in the elderly is complicated by age itself, multiple medical comorbidities, and anticoagulant and antiplatelet medications; therefore, the search for less invasive, yet more effective, treatment techniques has become a goal. Here, we present the use of a repurposed ventriculostomy catheter in the minimally invasive drainage of a mixed sSDH with the residual solid clot component subsequently liquefied with local alteplase (tPA) administration in an elderly female producing effective hematoma and symptom resolution.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Biomarker, Clinical, Journal: Factors predicting the outcome of intravenous thrombolysis in stroke patients before rt-PA administration. (Pubmed Central) - Dec 10, 2019
We enrolled 118 ischemic stroke patients who were treated with standard dose of Alteplase in our hospital...Significant predictors for outcome at 3 months according to multivariable regression analysis were NIHSS score (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.498-0.750; p<0.001), SBP (OR, 0.95; 95% CI, 0.925-0.991; P=0.01), AF (OR, 0.09; 95% CI, 0.013- 0.708; P=0.02), CAD (OR, 17.08; 95% CI, 0.013-0.708; p=0.003). Higher NIHSS score, higher SBP on admission, AF and history of CAD could be the independent predictors of outcome after IVT in acute ischemic stroke patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Neuroimaging selection for thrombectomy in pediatric stroke: a single-center experience. (Pubmed Central) - Nov 29, 2019
Perfusion imaging is feasible in pediatric stroke and may help identify salvageable tissue in extended time windows, though penumbral thresholds may differ from adult values. Further studies are needed to define criteria for thrombectomy in this unique population.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Status of prehospital delay and intravenous thrombolysis in the management of acute ischemic stroke in Nepal. (Pubmed Central) - Nov 23, 2019
Conclusions- Faster intravenous thrombolysis delivery is associated with less disability at 3 months among patients with large vessel occlusion. Community-based intervention to spread awareness, establishing comprehensive stroke centers, training specialists, improving emergency services, establishment of telestroke facilities and encouraging the use of low-cost tenecteplase as an alternative to alteplase can help improve care for stroke patients in Nepal.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Editorial: Reperfusion Therapy for Acute Ischemic Stroke. (Pubmed Central) - Nov 20, 2019
A higher sample size could provide more convincing results for TEM. No abstract available
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Analysis of related factors of orolingual angioedema after rt-PA intravenous thrombolytic therapy. (Pubmed Central) - Nov 11, 2019
If patients take an oral hypotension such as ACEI drugs before the onset of OA, they have a history of allergies, or the lesion is an infraction in the dominated area of the middle cerebral artery, the risk of OA after rt-PA intravenous thrombolytic therapy will be increased. The prevalence of OA should be monitored during the rt-PA intravenous thrombolytic therapy process; timely detection and early intervention should be conducted, which can avoid serious adverse consequences.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Comparative efficacy of various thrombolytic agents in treatment of pulmonary embolism (Pubmed Central) - Nov 10, 2019
However, by the stratified risk and frequency of PATE relapses, the condition of patients receiving alteplase turned out to be more severe. Based on the obtained results, a conclusion was made that actilyse is a drug of choice for treatment of patients with PATE.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Simultaneous cardio-cerebral embolization associated with atrial fibrillation: a case report. (Pubmed Central) - Nov 6, 2019
This dilemma has recently become evident in this era with mechanical thrombectomy strongly established as an effective intervention for acute ischemic stroke. Close cooperation between stroke physicians and cardiologists is becoming more important.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open: NOR-TEST 2: The Norwegian Tenecteplase Stroke Trial 2 (clinicaltrials.gov) - Oct 31, 2019
P3, N=1342, Recruiting,
Close cooperation between stroke physicians and cardiologists is becoming more important. Not yet recruiting --> Recruiting
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Uric acid enhances alteplase-mediated thrombolysis as an antioxidant. (Pubmed Central) - Oct 28, 2019
Compared with alteplase alone, the combination therapy reduced the infarct volume and inhibited haemorrhagic transformation. UA enhances alteplase-mediated thrombolysis, potentially by preventing oxidative stress, which inhibits fibrinolysis by alteplase in thrombi.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal, HEOR: Pharmacoeconomic impact of an alternative workflow process for stroke. (Pubmed Central) - Oct 27, 2019
UA enhances alteplase-mediated thrombolysis, potentially by preventing oxidative stress, which inhibits fibrinolysis by alteplase in thrombi. Preliminary data, in this pilot study, utilizing a multidisciplinary model for tPA administration led to significant cost savings of tPA and decreases in overall DTN administration times.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Review, Journal: Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence. (Pubmed Central) - Oct 27, 2019
Recent emerging literature and limited recommendation guidance from governing medical societies leave many emergency medicine providers to weigh benefit versus risk of fibrinolytic therapy and tenecteplase's place in therapy. This review evaluates the available literature regarding tenecteplase and its utility in the treatment of acute ischemic stroke patients.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Circadian rhythms may not influence the outcomes of thrombolysis in patients with ischemic stroke: A study from China. (Pubmed Central) - Oct 18, 2019
The impact of circadian rhythms on acute ischemic stroke (AIS) patients treated by recombinant alteplase (rt-PA) is still incongruent...In conclusion, there was no evidence to predict that circadian rhythms could influence the outcomes of AIS patients treated with rt-PA in China, although stroke onset during nighttime might aggravate neurological impairment before treatment. Further, multicenter and prospective clinical trials with larger number of subjects are still needed to draw more reliable conclusions.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal, HEOR: Is the Cost-Effectiveness of Stroke Thrombolysis Affected by Proportion of Stroke Mimics? (Pubmed Central) - Oct 17, 2019
Conclusions- We identified thresholds of SM above which thrombolysis was no longer cost-effective from 2 analytic perspectives. Hospitals should monitor SM rates and establish performance metrics to prevent rising acute stroke care costs and avoid potential patient harms.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Peritoneal Dialysis-Associated Peritonitis Presenting as Catheter Dysfunction (Exhibit Hall, Walter E. Washington Convention Center) - Oct 14, 2019 - Abstract #KIDNEYWEEK2019KIDNEY_WEEK_2781;
Alteplase was instilled sequentially for 30 minutes then 2 hours and large strands of fibrin cleared, permitting drainage of 50cc of cloudy effluent from which gram stain, cell count and cultures were sent...His course was complicated by CDiff enterocolitis, necessitating the addition of oral vancomycin...While fibrin can cause both one-way or two-way obstruction and is associated with peritonitis, there are no cases in the literature of peritonitis presenting this way. It is important to recognize this potential presentation as peritonitis events should prompt quality improvement efforts for both the individual patient and the PD program.
- |||||||||| fondaparinux / Generic Mfg.
Anticoagulation and Anti-Platelet Prescribing in Glomerular Disease: An Observational Study (Exhibit Hall, Walter E. Washington Convention Center) - Oct 14, 2019 - Abstract #KIDNEYWEEK2019KIDNEY_WEEK_1630;
Non-nephrotics (n=67) had heparin, enoxaparin, fondaparinux (46%, p<.0001 vs Nephrotics); aspirin (61%); warfarin (12%); alteplase, urokinase (9%); Xai (6%); and/or clopdiogrel, prasugrel, dipyriadamole (9%)...These variable practices suggest a need for further exploration of AC/AP indications/efficacy/ safety in GD patients. Funding Private Foundation Support
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Feasibility of low-dose infusion of alteplase for unsuccessful thrombolysis with urokinase in deep venous thrombosis. (Pubmed Central) - Oct 12, 2019
No symptomatic pulmonary embolism or major bleeding occurred during rescue thrombolysis, but minor bleeding complications occurred in 4 cases (15.4%). In conclusion, rescue thrombolysis with alteplase led to an effective and safe outcome in patients with DVT who did not respond to initial thrombolysis with urokinase, and may be a valid and easy alternative treatment option.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Modeling Stroke Patient Transport for All Patients With Suspected Large-Vessel Occlusion. (Pubmed Central) - Oct 11, 2019
Ischemic stroke with large-vessel occlusion can be treated with alteplase and/or endovascular therapy; however, the administration of each treatment is time sensitive...Based on current median treatment times to realize the full benefit of endovascular therapy on a population level, the study findings suggest that delivery of the treatment should be regionally centralized. The study modeling suggests that transport decision making is context specific and the radius of superiority of the transport strategy changes based on treatment times at both centers, transport times, and the triaging tool used.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment open, Trial completion date, Trial primary completion date: TOPCAT: t-PA Prophylaxis to Prevent Catheter-associated Thrombosis and Infection (clinicaltrials.gov) - Oct 9, 2019
P2, N=20, Recruiting,
The study modeling suggests that transport decision making is context specific and the radius of superiority of the transport strategy changes based on treatment times at both centers, transport times, and the triaging tool used. Not yet recruiting --> Recruiting | Trial completion date: Aug 2019 --> Dec 2019 | Trial primary completion date: Aug 2019 --> Dec 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Pulmonary embolism with cardiac arrest: a STEMI patient's unexpected course. (Pubmed Central) - Oct 9, 2019
Case description is followed by a review of the indications, safety, and dosing of systemic thrombolytic therapy for high-risk PE in the emergency department (ED). Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED.
- |||||||||| Praxbind (idarucizumab) / Boehringer Ingelheim, Pradaxa (dabigatran etexilate) / Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Intravenous alteplase and endovascular clot retrieval following reversal of dabigatran with idarucizumab. (Pubmed Central) - Oct 9, 2019
Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED. No abstract available
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Biomarker, Clinical, Journal: Door-in-Door-Out Time at Primary Stroke Centers May Predict Outcome for Emergent Large Vessel Occlusion Patients. (Pubmed Central) - Oct 8, 2019
Intravenous alteplase was administered to 64% of patients...Conclusions- For patients diagnosed with ELVO at a PSC who are being transferred to a CSC for thrombectomy, longer DIDO times may have a deleterious effect on outcomes and may represent the single biggest modifiable factor in onset to recanalization time. PSCs should make efforts to decrease DIDO and routine use of DIDO as a performance measure is encouraged.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: New aspects of thrombolysis and thrombectomy in pulmonary embolism (Pubmed Central) - Oct 8, 2019
In the case of contraindications for systemic thrombolysis surgical or alternatively, interventional thrombectomy should be performed. This article discusses these procedures in the light of the currently available literature.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Urticaria, angioedema, and type I hypersensitivity reactions associated with fibrinolytic agents. (Pubmed Central) - Oct 7, 2019
This article discusses these procedures in the light of the currently available literature. All fibrinolytic agents, either nonfibrin or fibrin-specific, can cause urticaria, angioedema, and type I hypersensitivity reactions due to their mechanism of action.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Post-hoc Analysis of Outcome of Intravenous Thrombolysis in Infarcts of Infratentorial Localization in the WAKE-UP Trial. (Pubmed Central) - Oct 3, 2019
The primary safety endpoint (death or mRS 4-6 at day 90) occurred in three patients of the alteplase group (13.6%) and three patients in the placebo group (12.0%); p = 0.74. WAKE-UP was underpowered for demonstrating treatment effect in subgroup analyses however, based on our current results, there is no evidence to recommend withholding MRI-guided thrombolysis in patients with unknown onset stroke of infratentorial localization.
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