- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Cerebral thrombolysis in patients with ischemic stroke and heart failure. (Pubmed Central) - Jun 15, 2019
The presence of systolic HF, defined according to an old and a new definition, does not determine safety and efficacy of cerebral iv-thrombolysis in patients with IS.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Factors affecting in-hospital delay of intravenous thrombolysis for acute ischemic stroke: A retrospective cohort study. (Pubmed Central) - Jun 5, 2019
This study was designed to investigate the factors affecting the in-hospital delay of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS).Two hundred and forty-eight consecutive AIS patients treated with intravenous administration of alteplase in Gansu Provincial Hospital from December 2014 to August 2018 were enrolled retrospectively in this study...Other baseline data and clinical features showed no significant difference between 2 groups (P > .05). Multivariate logistic regression analysis revealed that the risk of in-hospital delay was lower for the higher NIHSS score (OR = 0.775, 95% CI: 0.644-0.933, P = .007), the longer OTD time (OR = 0.963, 95% CI: 0.937-0.991, P = .010), the shorter decision-making time (OR = 1.224, 95% CI: 1.004-1.492, P = .045).This study suggested that NIHSS score, OTD time and decision-making time are the independent factors affecting the in-hospital delay of IVT for AIS.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Hemilingual Angioedema after Thrombolysis in a Patient on an Angiotensin II Receptor Blocker. (Pubmed Central) - May 29, 2019
Orolingual angioedema (OLAE) is a rare adverse effect of alteplase...Our case is the third documented case of OLAE occurring in a thrombolysed patient concurrently taking an ARB. The presence of hemilingual edema in a post-thrombolysis patient maintained on losartan suggests a possible association between OLAE and ARBs.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Adrenal hormones and circulating leukocyte subtypes in stroke patients treated with reperfusion therapy. (Pubmed Central) - May 24, 2019
...We investigated the course of immune cells and adrenocortical and adrenomedullary effectors in a cohort of 51 patients with acute stroke receiving reperfusion therapy (intravenous alteplase or mechanical thrombectomy) and its correlation with stroke outcomes and infarct growth...Then activation of cortical or medullar compartments of the adrenal gland result in specific signatures on leukocyte subpopulations. Manipulation of the adrenal gland hormone levels warrants further investigation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke. (Pubmed Central) - May 24, 2019
P3
There were more cases of symptomatic cerebral hemorrhage in the alteplase group than in the placebo group. (Funded by the Australian National Health and Medical Research Council and others; EXTEND ClinicalTrials.gov numbers, NCT00887328 and NCT01580839.).
- |||||||||| desmoteplase / Lundbeck, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Thrombolytic therapy of ischemic stroke (Pubmed Central) - May 22, 2019
Another group of thrombolytic agents includes derivatives of flora and fauna - external plasminogen activators, of which streptokinase, staphylokinase, and desmoteplase are most common drugs. These medications are not a structural part of the human organism, and overcoming of immunogenicity while preserving fibrinolytic activity and fibrin specificity is one of the main tasks in applying them in clinical practice.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Time window and "tissue window": two approaches to assist decision-making in strokes. (Pubmed Central) - May 22, 2019
Intravenous alteplase given in an appropriate time window has been recommended in guidelines and effects are on the decline over time...In the later sections, we give the details of the definition of "tissue window", and then compare various neuroimaging techniques to determine the penumbra and summarize favorable patterns. Finally, we will focus on how the "tissue window" extends the therapeutic time window under specific circumstances.
- |||||||||| Xarelto (rivaroxaban) / Bayer, J&J, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Predictors of Chronic Thromboembolic Pulmonary Hypertension. (Pubmed Central) - May 22, 2019
Of concomitant diseases, significant risk factors for development of CTEPH were grade 3 hypertensive disease, diabetes mellitus, post-infarction cardiosclerosis. On the other hand, age, gender, degree of severity at the time of admission, presence of infarction pneumonia, surgical prevention of recurrent pulmonary embolism, number of pregnancies and deliveries, history of trauma and malignancies, cardiac arrhythmias produced no significant impact on the development of CTEPH.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date: INTRECIS: Intravenous Thrombolysis Registry for Chinese Ischemic Stroke Within 4.5 h Onset (clinicaltrials.gov) - May 17, 2019
P=N/A, N=4000, Recruiting,
On the other hand, age, gender, degree of severity at the time of admission, presence of infarction pneumonia, surgical prevention of recurrent pulmonary embolism, number of pregnancies and deliveries, history of trauma and malignancies, cardiac arrhythmias produced no significant impact on the development of CTEPH. Trial completion date: Dec 2019 --> Aug 2019
- |||||||||| Lucentis (ranibizumab) / Roche, Novartis, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Enrollment closed, Trial completion date, Trial primary completion date: TAPAS: Intravitreal tPA and C3F8 for the Treatment of Submacular Haemorrhage as a Complication of Neovascular AMD (clinicaltrials.gov) - May 16, 2019
P2/3, N=55, Active, not recruiting,
Trial completion date: Dec 2019 --> Aug 2019 Recruiting --> Active, not recruiting | Trial completion date: Nov 2019 --> May 2020 | Trial primary completion date: Nov 2018 --> Nov 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Retrospective data, Journal: Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. (Pubmed Central) - May 15, 2019
EVT achieves better outcomes at 90 days than standard medical therapy across a broad range of baseline imaging categories, including infarcts affecting more than 33% of middle cerebral artery territory or ASPECTS less than 6, although in these patients the risk of symptomatic intracranial haemorrhage was higher in the EVT group than the control group. This analysis provides preliminary evidence for potential use of EVT in patients with large infarcts at baseline.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Egyptian experience in increasing utilization of reperfusion therapies in acute ischemic stroke. (Pubmed Central) - May 7, 2019
The second study showed that out of 284 cases admitted with acute ischemic stroke, 37 were eligible for thrombolysis and 35 received alteplase(tPA) (94.3%), representing 12.3% of the total ischemic stroke admissions. Conclusion A comprehensive action plan that centers around making the drug available and training resulted in a significant improvement of reperfusion therapy utilization in Egypt.
- |||||||||| Pulmozyme (dornase alfa) / Roche, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial primary completion date: Fibrinolytic Therapy Versus Medical Thoracoscopy (clinicaltrials.gov) - May 7, 2019
P4, N=70, Recruiting,
Conclusion A comprehensive action plan that centers around making the drug available and training resulted in a significant improvement of reperfusion therapy utilization in Egypt. Trial completion date: Apr 2019 --> May 2020 | Trial primary completion date: Apr 2019 --> May 2020
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, P3 data, Clinical Trial,Phase I, Clinical Trial,Phase II, Clinical Trial,Phase III, Journal: Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial. (Pubmed Central) - May 2, 2019
P3
For moderate to large intracerebral haemorrhage, MISTIE did not improve the proportion of patients who achieved a good response 365 days after intracerebral haemorrhage. The procedure was safely adopted by our sample of surgeons.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: The role of endogenous tissue-type plasminogen activator in neuronal survival after ischemic stroke: friend or foe? (Pubmed Central) - Apr 28, 2019
Endogenous protease tissue-type plasminogen activator (tPA) has highly efficient fibrinolytic activity and its recombinant variants alteplase and tenecteplase are established as highly effective thrombolytic drugs for ischemic stroke...Then we focus on possible hypotheses about why and how endogenous tPA mediates ischemic neuronal death and survival. Finally, we analyze how endogenous tPA affects neuron fate in ischemic stroke in a comprehensive view.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Professional guideline versus product label selection for treatment with IV thrombolysis: An analysis from SITS registry. (Pubmed Central) - Apr 23, 2019
...If all patients were treated by ESO guidelines, an additional 17,031 would receive alteplase, which translates into 1922 more patients with favourable three-month outcomes...Closer alignment with professional guidelines would increase patients treated and favourable outcomes. Product labels should be revised to allow treatment of patients ≤4.5 h from onset and aged ≥80 years.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Drip and ship versus direct to endovascular thrombectomy: The impact of treatment times on transport decision-making. (Pubmed Central) - Apr 23, 2019
...It is unknown if bypassing thrombolysis centres in favour of endovascular thrombectomy (mothership) outweighs transport to the nearest thrombolysis centre for alteplase and then transfer for endovascular thrombectomy (drip-and-ship)...A moderate improvement in treatment times results in significant predicted changes to the optimisation of a national acute stroke patient transport strategy. Modelling patient transport for system-level planning is sensitive to treatment times at both thrombolysis and thrombectomy centres and has important implications for the future planning of thrombectomy services.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal: Women on Hormone Therapy with Ischemic Stroke, Effects on Deficits and Recovery. (Pubmed Central) - Apr 23, 2019
...We included all women consults regardless of IV Alteplase treatment...The mRS scores at three months indicated significant improvements among HT users vs. non-HT use (1.46 ± 0.4 vs. 2.51 ± 0.2, p=0.05). While cautions persist on the use, route and dosage of HT for risks of ischemic stroke, the HT moderation of AIS deficits and outcomes in women <80 years of age warrants further investigation.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion date, Trial termination, Trial primary completion date: Thrombolysis in Ischemic Spinal Cord Stroke (clinicaltrials.gov) - Apr 20, 2019
P2, N=12, Terminated,
This experience may help guide the design of a randomized controlled trial to determine the safety and efficacy of low-dose alteplase for submassive pulmonary embolism. Trial completion date: Oct 2018 --> Mar 2019 | Active, not recruiting --> Terminated | Trial primary completion date: Oct 2018 --> Mar 2019
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Preclinical, Journal: Alteplase and DNase for the treatment of pleural empyema in rats. (Pubmed Central) - Apr 18, 2019
Trial completion date: Oct 2018 --> Mar 2019 | Active, not recruiting --> Terminated | Trial primary completion date: Oct 2018 --> Mar 2019 Alteplase, DNase and alteplase + DNase changed significantly physical and chemical properties of experimental empyema at fibrinopurulent phase: alteplase reduced molecular size larger than 135 nm and DNase reduced viscosity.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Minimally invasive surgery plus alteplase for intracerebral haemorrhage. (Pubmed Central) - Apr 16, 2019
Alteplase, DNase and alteplase + DNase changed significantly physical and chemical properties of experimental empyema at fibrinopurulent phase: alteplase reduced molecular size larger than 135 nm and DNase reduced viscosity. No abstract available
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Review, Journal: Telehealth for Remote Stroke Management. (Pubmed Central) - Apr 7, 2019
...We also present evidence that the safety and effectiveness of intravenous alteplase in community hospitals in a telestroke network seems to be comparable with that achieved in dedicated stroke centres...Telestroke networks can also be used for identification and enrollment of patients into emergency stroke trials and thus provide a more representative sample of the population and increase recruitment. Standardization of regional telestroke networks could lead to collaborations with larger data acquisitions for research purposes and quality control in the future.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion: HaemInCor: Intramyocardial Haemorrhage in Patients With Primary STEMI (clinicaltrials.gov) - Apr 5, 2019
P=N/A, N=60, Completed,
Standardization of regional telestroke networks could lead to collaborations with larger data acquisitions for research purposes and quality control in the future. Recruiting --> Completed
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, Journal, HEOR: Cost-effectiveness of targeted thrombolytic therapy for stroke patients using multi-modal CT compared to usual practice. (Pubmed Central) - Apr 3, 2019
Recruiting --> Completed In a healthcare setting where multimodal imaging technologies are available and reimbursed, their use in screening patients presenting with acute stroke to determine eligibility for alteplase treatment is cost-effective given a range of willingness-to-pay thresholds and warrants consideration as an alternative to routine practice.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Journal: Thrombolysis: Improving door-to-needle times for ischemic stroke treatment - A narrative review. (Pubmed Central) - Mar 27, 2019
There are many exciting areas of future direction including reduction of door-to-needle time in developing countries, improving pre-hospital response times, and improving the efficiency of endovascular treatment. Conclusions There is now a broad understanding of the causes of delays to fast treatment and the strategies that can be employed to improve door-to-needle time such that most centers could achieve median door-to-needle time of 30 min.
- |||||||||| voriconazole / Generic mfg., Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Clinical, Journal, HEOR: Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts. (Pubmed Central) - Mar 21, 2019
Conclusions There is now a broad understanding of the causes of delays to fast treatment and the strategies that can be employed to improve door-to-needle time such that most centers could achieve median door-to-needle time of 30 min. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Hakko Kirin, Mitsubishi Tanabe
Clinical, P3 data, Clinical Trial,Phase I, Clinical Trial,Phase II, Clinical Trial,Phase III, Journal: Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial. (Pubmed Central) - Mar 21, 2019
P3
These results might not support a major shift towards this treatment being applied in those receiving alteplase for mild-to-moderate acute ischaemic stroke. Further research is required to define the underlying mechanisms of benefit and harm resulting from early intensive blood pressure lowering in this patient group.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Trial completion, Trial completion date, Trial primary completion date: Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) (clinicaltrials.gov) - Mar 6, 2019
P3, N=4587, Completed,
N=50 --> 350 Recruiting --> Completed | Trial completion date: Feb 2019 --> Aug 2018 | Trial primary completion date: Dec 2018 --> Aug 2018
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