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reteplase versus alteplase in stroke

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https://www.readbyqxmd.com/read/23836425/a-critical-analysis-of-intra-arterial-thrombolytic-doses-in-acute-ischemic-stroke-treatment
#1
Ameer E Hassan, Foad Abd-Allah, Saqib A Chaudhry, Malik M Adil, Nassir Rostambeigi, Adnan I Qureshi
BACKGROUND: Intra-arterial thrombolytics (IAT) such as Alteplase, Tenecteplase, and Reteplase are currently used in patients with acute ischemic stroke in varying doses. We evaluated the relationship of IA thrombolytic dose with angiographic recanalization, intracerebral hemorrhage (ICH) rates, and clinical outcomes at three comprehensive stroke centers. METHODS: We stratified patients who underwent endovascular treatment into tertiles based on intra-arterial thrombolytic dose administered: lower tertile (range 1...
August 2014: Neurocritical Care
https://www.readbyqxmd.com/read/18673235/fibrin-binding-and-the-regulation-of-plasminogen-activators-during-thrombolytic-therapy
#2
REVIEW
C Longstaff, S Williams, C Thelwell
First generation thrombolytics (streptokinase and urokinase) had no fibrin binding capabilities and caused systemic plasminogen activation with concomitant destruction of haemostatic proteins. A primary driving force behind the development of the second generation plasminogen activator tissue plasminogen activator (tPA or alteplase) was its ability to bind to fibrin and target thrombolysis. Although in vitro assays highlighted advantages of fibrin binding, clinical trials were disappointing, showing only small benefits in mortality with tPA versus streptokinase, but also with some increase in haemorrhagic stroke...
July 2008: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/17263591/spotlight-on-reteplase-in-thrombotic-occlusive-disorders
#3
REVIEW
Dene Simpson, M Asif A Siddiqui, Lesley J Scott, Daniel E Hilleman
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus dose (nonweight-based), rather than an infusion, which promotes rapid and safe administration. The ease of administration of this reteplase dosage regimen (two 10U bolus doses, each over 2 minutes, 30 minutes apart) is conducive to prehospital initiation of thrombolytic treatment in patients with ST-segment elevation myocardial infarction (STEMI), which reduces the time to treatment, a critical factor in improving long-term survival...
2007: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/16913828/reteplase-a-review-of-its-use-in-the-management-of-thrombotic-occlusive-disorders
#4
REVIEW
Dene Simpson, M Asif A Siddiqui, Lesley J Scott, Daniel E Hilleman
Reteplase (Retavase) is a plasminogen activator, mimicking endogenous tissue plasminogen activator (t-PA), a serine protease, converting plasminogen to plasmin and thereby precipitating thrombolysis. It is a third-generation recombinant form of t-PA that operates in the presence of fibrin (i.e. it is fibrin specific). Reteplase can be administered as a bolus dose (nonweight-based) rather than an infusion, which promotes rapid and safe administration. The ease of administration of this reteplase dosage regimen (two 10U bolus doses, each over 2 minutes, 30 minutes apart) is conducive to prehospital initiation of thrombolytic treatment in patients with ST-segment elevation myocardial infarction (STEMI), which reduces the time to treatment, a critical factor in improving long-term survival...
2006: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/10513773/effectiveness-of-early-coronary-angioplasty-and-abciximab-for-failed-thrombolysis-reteplase-or-alteplase-during-acute-myocardial-infarction-results-from-the-gusto-iii-trial-global-use-of-strategies-to-open-occluded-coronary-arteries
#5
RANDOMIZED CONTROLLED TRIAL
J M Miller, R Smalling, E M Ohman, C Bode, A Betriu, N S Kleiman, J S Schildcrout, E Bastos, E J Topol, R M Califf
We evaluated the effects of abciximab treatment during early angioplasty after clinically failed thrombolysis for acute myocardial infarction. In the Global Use of Strategies To Open occluded coronary arteries (GUSTO-III) trial of reteplase versus alteplase for acute infarction (n = 15,059), 392 patients underwent angioplasty a median of 3.5 hours after thrombolysis and had complete procedural data. We compared 30-day mortality and in-hospital outcomes between patients who received abciximab (n = 83) and those who did not (n = 309), and (among patients given abciximab) between those randomized to alteplase versus reteplase...
October 1, 1999: American Journal of Cardiology
https://www.readbyqxmd.com/read/10385761/hemodynamic-effects-of-double-bolus-reteplase-versus-alteplase-infusion-in-massive-pulmonary-embolism
#6
RANDOMIZED CONTROLLED TRIAL
U Tebbe, A Graf, W Kamke, R Zahn, F Forycki, G Kratzsch, G Berg
BACKGROUND: Thrombolytic agents are given in massive pulmonary embolism to dissolve or reduce the clot and normalize hemodynamics. Comparative clinical studies have shown that administration of a 2-hour infusion of alteplase is more effective than urokinase over a 12-hour period. Reteplase is a new generation thrombolytic with a longer half-life that can be administered more conveniently as a double bolus. We compared efficacy and safety of reteplase with the approved regimen of alteplase in massive pulmonary embolism...
July 1999: American Heart Journal
https://www.readbyqxmd.com/read/10342921/reteplase-new-preparation-minimal-value-bolus-versus-infusion
#7
COMPARATIVE STUDY
(no author information available yet)
The clinical file on reteplase is methodologically sound. A trial versus alteplase involving more than 15 000 patients seen less than 6 hours after myocardial infarction showed that mortality at 30 days was identical in the reteplase and alteplase treatment groups (7.3%). The two treatment groups did not differ either in the frequency of strokes or severe bleeding. Another trial involving more than 6 000 patients seen less than 12 hours after myocardial infarction showed that overall mortality 35 days after thrombolysis was 9% in both the reteplase and the streptokinase treatment groups...
June 1998: Prescrire International
https://www.readbyqxmd.com/read/8990406/patency-trials-with-reteplase-r-pa-what-do-they-tell-us
#8
REVIEW
C Bode, T K Nordt, K Peter, R W Smalling, M S Runge, W K├╝bler
Thrombolytic therapy has been shown to reduce mortality and morbidity after acute myocardial infarction. Therapeutic benefit seems to be directly correlated with completeness of reperfusion (Thrombolysis in Myocardial Infarction [TIMI] grade 3 flow) of the infarct-related coronary artery, as well as the timeliness of reperfusion. To determine which regimen of reteplase (r-PA), a deletion mutant of wild-type tissue plasminogen activator (t-PA), is most effective for clinical thrombolysis, several reteplase regimens were compared with the most successful standard regimens of recombinant t-PA (alteplase) in 2 large-scale, randomized studies...
December 19, 1996: American Journal of Cardiology
https://www.readbyqxmd.com/read/8790022/randomized-comparison-of-coronary-thrombolysis-achieved-with-double-bolus-reteplase-recombinant-plasminogen-activator-and-front-loaded-accelerated-alteplase-recombinant-tissue-plasminogen-activator-in-patients-with-acute-myocardial-infarction-the-rapid-ii-investigators
#9
RANDOMIZED CONTROLLED TRIAL
C Bode, R W Smalling, G Berg, C Burnett, G Lorch, J M Kalbfleisch, R Chernoff, L G Christie, R L Feldman, A A Seals, W D Weaver
BACKGROUND: The therapeutic benefit of thrombolytic therapy has been shown to correlate directly with completeness (TIMI grade 3 flow) and speed of reperfusion of the infarct-related coronary artery. The purpose of the RAPID II study was to determine whether a double-bolus regimen of reteplase, a recently developed deletion mutant of wild-type tissue plasminogen activator, could improve 90-minute coronary artery patency rates achieved with the most successful standard regimen, an "accelerated" front-loaded infusion of alteplase...
September 1, 1996: Circulation
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