Direct oral anticoagulants (DOAC) have emerged as safe and efficacious ischemic stroke prophylaxis for non-valvular atrial fibrillation (NVAF). All four DOACs - apixaban, dabigatran, edoxaban, rivaroxaban - were associated with lower risks of major bleeding compared to warfarin. Listed as core essential medicines by the World Health Organization, DOAC prescriptions have been surging worldwide. In Hong Kong, approximately 80,000 patients received DOACs from January 2009 through December 2022 according to the Hospital Authority registry.
The widespread DOAC usage had created DOAC-specific clinical dilemmas that lack evidence-based treatment despite twenty years of prescribing experience. Ischemic stroke despite DOAC (IS-DOAC), in particular, may occur in up to 6% of DOAC users annually. Due to the in vivo anticoagulation effect, there had been concerns of intracerebral bleeding (ICH) with intravenous thrombolytic therapy (IVT) for acute IS-DOAC. Under the current guideline recommendations, most acute IS-DOAC are contraindicated to IVT (see Intravenous thrombolytic therapy), which resulted in only a small proportion of acute ISDOAC patients being able to receive IVT even if presented early. Nonetheless, our group found that majority of patients had a DOAC level of <50ng/mL only 24 hours after DOAC cessation (see work done by us), a level deemed clinically negligible and safe for thrombolytic therapy. Together with evolving clinical evidence discussed below, IS-DOAC patients maybe unnecessarily barred from IVT, thus compromised functional recovery.
With robust pharmacokinetic and retrospective clinical evidence to support, it is hypothesized that IVT are safe in IS-DOAC patient. The investigators hereby propose a prospective multicenter study to determine the efficacy and safety of IVT in acute IS-DOAC.

Start Date05 Mar 2024

Sponsor / Collaborator

The Chinese University of Hong Kong

[+6]

NCT06194968 / RecruitingNot ApplicableIIT

Treatment of Acute Ischemic StroKe With Intravenous UroKinase Real-world Research: a Multicenter, Prospective Study (TASK-UK)

The purpose of this study is to to compare the safety and effectiveness of IV urokinase with IV alteplase in the treatment of AIS in patients up to 6 hours from symptom onset.

Start Date30 Dec 2023

Sponsor / Collaborator

The First Affiliated Hospital of Zhengzhou University

[+1]

NCT06115070 / RecruitingPhase 4

ALteplase for the Treatment of Acute Ischemic Stroke in Patients With LOW National Institutes of Health Stroke Scale and Specified Disabling Deficits

About 1/3 patients with mild stroke have poor prognosis, whether patients with this type undergo thrombolysis has been a controversial issue. A pooled analysis published in the Lancet in 2014 included 9 high-quality RCT studies of intravenous thrombolysis such as NINDS and IST3, and a total of 666 (10%) patients with mild stroke were included in the analysis. For mild stroke, the proportion of good prognosis in the control group and the alteplase group was 58.9% and 68.7% (OR 1.48, 95%Cl 1.07-2.06), respectively. Therefore, guidelines recommended alteplase thrombolytic therapy for patients with mild stroke. However, PRISMS, a randomized controlled trial of intravenous thrombolytic therapy for mild stroke published in 2018, found that alteplase intravenous thrombolytic therapy did not improve clinical outcomes compared with aspirin in patients with mild non-disabled stroke (90-day mRS 0-1 ratio 78.2% vs 81.5%), and the incidence of symptomatic intracranial hemorrhage was higher. However, a major limitation of the PRISMS study was that more than 85% of patients had numbness and dysarticulation, so this conclusion cannot be extrapolated to patients with other mild stroke symptoms. Moreover, due to the early termination of the sponsorship of this trial, the number of enrolled cases did not reach the pre-designed number, resulting in a serious decline in the authenticity of the study results.
Symptoms and outcomes of minor stroke are important criteria for assessment. However, there is currently no uniform standard for the assessment of disability. Therefore, the center developed a mild stroke EMSS assessment scale to refine the disability assessment of stroke symptoms. It was found that intravenous thrombolytic therapy was safe and effective for patients with symptoms such as dizziness, disorientation, memory impairment, decreased muscle strength at the proximal end of one limb, and ataxia while standing.
Therefore, the purpose of this study was to investigate whether ischemic stroke patients with onset or detection time within 4.5 hours, and mild stroke patients with NIHSS score ≤5 with any of the following symptoms: dizziness, disorientation, memory impairment, single proximal muscle strength decline, or ataxia while standing could benefit from intravenous thrombolysis based on CT/MRI screening in the Chinese population.

Start Date17 Nov 2023

Sponsor / Collaborator

Second Affiliated Hospital Zhejiang University School of Medicine

100 Clinical Results associated with Alteplase

100 Translational Medicine associated with Alteplase

100 Patents (Medical) associated with Alteplase

14,214

Literatures (Medical) associated with Alteplase

31 Dec 2024·Annals of medicine

Effects of intravenous rtPA in patients with minor stroke

Article

Author: Hu, Shiyu ; Lei, Zhihao ; Feng, Hongye ; Li, Shuanglin ; Li, Jun ; Ren, Lijie ; Wu, Xiaohong ; Pan, Suyue ; Xu, Gelin

BACKGROUND:

Whether minor ischemic stroke (MIS) patients can benefit from intravenous thrombolysis (IVT) remains controversial. The association between the efficacy of IVT and baseline National Institute of Health Stroke Scale (NIHSS) score is unclear in MIS, while the association in moderate and severe stroke is known. This study aimed to explore the effect of IVT in patients with MIS and analyze its efficacy in patients with different baseline NIHSS scores.

METHODS:

Patients with a NIHSS score ≤5 within 4.5 h of stroke onset were screened in 32 centers. Patients with and without IVT were matched to a ratio of 1:1 with propensity scores. An excellent outcome was defined as a modified Rankin Scale (mRS) score ≤1 at three months after stroke onset. Safety outcomes included mortality and symptomatic intracranial hemorrhage (sICH). Multivariate analysis was used to compute the adjusted odds ratio (OR) for excellent outcomes. The effect of IVT was further analyzed in subgroups according to the baseline NIHSS score.

RESULTS:

Of the 23,853 screened, 3336 patients with MIS who arrived at the hospital within 4.5 h of onset were included. The 1163 patients treated with IVT were matched with 1163 patients without IVT. IVT in minor strokes generated an adjusted OR of 1.38 (95% CI: 1.09-1.75, p = 0.009) for excellent outcomes. There were no significant differences in mortality (0.17% vs. 0.09%, p = 1.000) and sICH (0.69% vs. 0.86%, p = 0.813) between patients with and without IVT. Subgroup analysis showed that there was no significant effect of IVT in the baseline NIHSS 0-1 or 2-3 subgroups, with adjusted OR of 0.816 (95% CI 0.437-1.53, p = 0.525) and1.22 (95% CI 0.845-1.77, p = 0.287), respectively. In patients with NIHSS score of 4-5, IVT was significantly effective, with an adjusted OR of 1.53 (95% CI 1.02-2.30, p = 0.038).

CONCLUSION:

IVT can improve MIS outcomes. The risks of sICH and mortality did not increase, especially in patients with NIHSS scores 4 to 5, who could benefit from IVT significantly.

01 Jul 2024·Current reviews in clinical and experimental pharmacology

Intrapleural Thrombolytics for Parapneumonic Effusion: A Network Metaanalysis

Article

Author: Sridharan, Kannan ; Sivaramakrishnan, Gowri

Objectives::

Intrapleural thrombolytics have been trialed for facilitating pleural fluid drainage in patients with complicated parapneumonic effusion. The present study is a network metaanalysis of randomized clinical trials (RCTs) that have evaluated these thrombolytics.

Methods::

Electronic databases (Medline, Cochrane CENTRAL, and Google Scholar) were searched for appropriate RCTs evaluating the therapeutic effect of thrombolytics in patients with complicated parapneumonic effusion. Mortality, the proportion of patients referred for surgical intervention, and serious adverse events were the outcome measures. Random-effects model was used for generating direct and mixed treatment comparison pooled estimates. Grading of the evidence for key comparisons was carried out. Odds ratio with 95% confidence intervals was used to represent the pooled estimates.

Results::

Seventy-six studies were retrieved with the search strategy, of which 16 were included. No significant differences were observed in mortality. Compared to normal saline, significantly less proportion of patients was referred for surgical intervention with streptokinase (0.4, 0.2 to 0.8), urokinase (0.4, 0.2 to 0.8), alteplase (0.3, 0.1 to 0.7), and alteplase + DNase (0.2, 0.1 to 0.7). DNase alone increased the risk of referral to surgical intervention (3.4, 1.5 to 7.6). Only streptokinase was observed with an increased risk of serious adverse events compared to normal saline (2.8, 1.1 to 7.1) and alteplase (6.7, 1.1 to 39.9). Moderate quality of evidence was observed for streptokinase with normal saline for the proportion of patients referred for surgical intervention, while either low or very low quality strength was observed for all other comparisons.

Conclusion::

Streptokinase, urokinase, alteplase, and alteplase + DNase were observed in patients referred for surgical interventions when used intrapleural in patients with parapneumonic effusion. Alteplase + DNase is likely to outperform others as it was observed with the least risk of patients referred for surgical interventions. Until additional data emerges that changes the pooled estimates, thrombolytics other than streptokinase are preferred due to the increased risk of serious adverse events.

01 Mar 2024·Molecular neurobiology

Surface-Tailored Nanoplatform for the Diagnosis and Management of Stroke: Current Strategies and Future Outlook

Review

Author: Shah, Hinal ; Paul, Gajanan ; Yadav, Awesh K

Stroke accounts for one of the top leading reasons for neurological mortality and morbidity around the globe. Both ischemic and hemorrhagic strokes lead to local hypoxia and are brought about by the occlusion or rupturing of the blood vessels. The events taking place after the onset of a stroke include membrane ion pump failure, calcium and glutamate-mediated excitotoxicity, increased ROS production causing DNA damage, mitochondrial dysfunction, oxidative stress, development of brain edema, and microvascular dysfunction. To date, tissue plasminogen activator (tPA) therapy and mechanical removal of blood clots are the only clinically available stroke therapies, approved by Food and Drug Administration (FDA). But because of the narrow therapeutic window of around 4.5 h for tPA therapy and complications like systemic bleeding and anaphylaxis, more clinical trials are ongoing in the same field. Therefore, using nanocarriers with diverse physicochemical properties is a promising strategy in treating and diagnosing stroke as they can efficiently bypass the tight blood-brain barrier (BBB) through mechanisms like receptor-mediated transcytosis and help achieve controlled and targeted drug delivery. In this review, we will mainly focus on the pathophysiology of stroke, BBB alterations following stroke, strategies to target BBB for stroke therapies, different types of nanocarriers currently being used for therapeutic intervention of stroke, and biomarkers as well as imaging techniques used for the detection and diagnosis of stroke.

News (Medical) associated with Alteplase

25 Jun 2024

·www.biospace.com

NervGen Pharma to Advance NVG-300 into Preclinical Proof-of-Concept Stage

New molecule demonstrates efficacy in a challenging SCI model Expanding pipeline into new indications of ischemic stroke and ALS Vancouver, British Columbia--(News - June 25, 2024) - NervGen Pharma Corp. (TSXV: NGEN) (OTCQB: NGENF), a clinical-stage biotech company dedicated to developing innovative solutions for the treatment of nervous system damage, today announced its plans for the development of a new drug candidate, NVG-300, with a focus on three initial indications: ischemic stroke, amyotrophic lateral sclerosis (ALS) and spinal cord injury (SCI). NVG-300 is a new biologic molecule discovered at NervGen. Pending successful preclinical validation, NVG-300 will be developed under the Biologics License Application regulatory framework providing 12 years of market exclusivity post-approval. NVG-300's composition of matter intellectual property protection is expected to extend beyond 2040. The discovery of NVG-300 is the result of a research effort initiated by NervGen in 2022, leveraging the extensive internal expertise and the evolving scientific understanding of the mechanisms involved in nervous system repair. NVG-300 is the first of what the company believes will be a pipeline of new molecules addressing high unmet need neurologic indications. NVG-300 product and process development have progressed to successfully establish manufacturability and feasibility of high concentration liquid formulation to enable self-administration of the product in a prefilled syringe format. "We are excited to advance NVG-300 toward development based on promising efficacy observed in a model of SCI characterized by heightened severity of spinal cord damage and impaired spontaneous recovery," said NervGen's Vice President of Research and Preclinical Development, Dr. Matvey Lukashev. "Based on these results, we are conducting formulation development, advancing further preclinical evaluation of NVG-300 in SCI and initiating efficacy studies in preclinical models of ischemic stroke and ALS. The results from these preclinical studies are expected in early 2025." "Early signs of preclinical efficacy and favorable pharmaceutical properties provided the evidence we needed to advance NVG-300 into expanded indications characterized by nervous system damage," said Mike Kelly, NervGen's President and CEO. "While our lead product candidate, NVG-291, remains the key focus of the company, we expect NVG-300 to add diversity to our pipeline and provide strategic optionality for future partnering opportunities. As a pioneer and an emerging leader in the development of pharmacological interventions targeting the mechanisms that inhibit nervous system repair, we focus our research and development efforts to ensure we remain at the forefront of this exciting new therapeutic field." About Ischemic Stroke Stroke is the leading cause of death and severe disability worldwide, significantly diminishing the quality of life for many affected individuals. Globally, nearly 17 million people experience a stroke each year, with over two million cases annually in the United States, Europe, and Japan combined. The most prevalent type of stroke, ischemic stroke, occurs when a blockage in the brain's blood flow deprives it of oxygen and nutrients, often leading to long-term or permanent neurological damage. Unfortunately, treatment options for ischemic stroke are limited. Current therapies, such as the administration of the clot-dissolving agent tissue plasminogen activator or surgical clot removal, must generally be performed within a few hours of stroke onset. About Amyotrophic Lateral Sclerosis (ALS) ALS is an invariably fatal progressive neurodegenerative disorder caused by loss of motor neurons and resulting in loss of voluntary muscle function, culminating in respiratory paralysis and death, usually within 2-5 years after diagnosis. Roughly 1 in 400 people will develop ALS in their lifetime. There are an estimated 30,000 people in the United States and more than 30,000 people in Europe (European Union and United Kingdom) living with ALS at any given time. About Spinal Cord Injury (SCI) SCI resulting from trauma causes disruption of the signals normally transmitted between the brain and the body, frequently resulting in severe functional impairment below the level of the injury. Every year, up to 500,000 people globally suffer from SCI. Each individual with SCI faces an expected lifetime cost of care between $1M and $4M, depending on severity and age at injury. Existing treatments are limited to surgical stabilization and physical rehabilitation, which result in partial improvement. There are currently no U.S. Food and Drug Administration-approved treatments that can promote repair and improve function following SCI. About NervGen NervGen (TSXV: NGEN) (OTCQB: NGENF) is a clinical-stage biotech company dedicated to developing innovative treatments that enable the nervous system to repair itself following damage, whether due to injury or disease. NervGen's lead drug candidate, NVG-291, is currently being evaluated in a Phase 1b/2a clinical trial in the company's initial target indication, spinal cord injury. For more information, visit or follow NervGen on X, LinkedIn, and Facebook for the latest news on the company. Contacts Huitt Tracey, Investor Relations htracey@nervgen.com 604.362.6209 Bill Adams, Chief Financial Officer info@nervgen.com 778.731.1711 David Schull or Ignacio Guerrero-Ros, Ph.D. Russo Partners david.schull@russopartnersllc.com ignacio.guerrero-ros@russopartnersllc.com 858.717.2310 646.942.5604 Neither the TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release. Cautionary Note Regarding Forward-Looking Statements This news release may contain "forward-looking information" and "forward-looking statements" within the meaning of applicable Canadian and United States securities legislation. Such forward-looking statements and information herein include, but are not limited to, the Company's current and future plans, expectations and intentions, results, levels of activity, performance, goals or achievements, or any other future events or developments constitute forward-looking statements, and the words "may", "will", "would", "should", "could", "expect", "plan", "intend", "trend", "indication", "anticipate", "believe", "estimate", "predict", "likely" or "potential", or the negative or other variations of these words or other comparable words or phrases, are intended to identify forward-looking statements. Forward-looking statements include, without limitation, statements relating to: the development plans and timelines for NVG-300; the objectives, study design, planned clinical endpoints, timing, expected rate of enrollment and data readout of our Phase 1b/2a clinical trial in individuals with spinal cord injury; future plans for our pipeline development; the belief that targeting mechanisms that interfere with nervous system repair is a promising target for reducing the clinical effects of nervous system damage through multiple mechanisms; and the creation of innovative treatments of nervous system damage due to trauma or disease. Forward-looking statements are based on estimates and assumptions made by the Company in light of management's experience and perception of historical trends, current conditions and expected future developments, as well as other factors that we believe are appropriate and reasonable in the circumstances. In making forward-looking statements, the Company has relied on various assumptions, including, but not limited to: the Company's ability to manage the effects of pandemics such as COVID-19; the accuracy of the Company's financial projections; the Company obtaining positive results in its clinical and other trials; the Company obtaining necessary regulatory approvals; and general business, market and economic conditions. Many factors could cause our actual results, level of activity, performance or achievements or future events or developments to differ materially from those expressed or implied by the forward-looking statements, including without limitation, a lack of revenue, insufficient funding, the impact of pandemics such as the COVID-19, reliance upon key personnel, the uncertainty of the clinical development process, competition, and other factors set forth in the "Risk Factors" section of the Company's Annual Information Form, Prospectus Supplement, financial statements and Management Discussion and Analysis which can be found on SEDARplus.ca. All clinical development plans are subject to additional funding. Readers should not place undue reliance on forward-looking statements made in this news release. Furthermore, unless otherwise stated, the forward-looking statements contained in this news release are made as of the date of this news release, and we have no intention and undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by applicable law. The forward-looking statements contained in this news release are expressly qualified by this cautionary statement. To view the source version of this press release, please visit

24 Jun 2024

·www.sciencedaily.com

Standardized protocols help hospitals treat strokes faster

Research illustrates that American Heart Association and American Stroke Association guidelines are effective at speeding up hospitals' response times for stroke treatment and can be mastered even by members of 'ad hoc' medical teams that assemble rapidly on the fly. West Virginia University research illustrates that American Heart Association and American Stroke Association guidelines are effective at speeding up hospitals' response times for stroke treatment and can be mastered even by members of "ad hoc" medical teams that assemble rapidly on the fly. Swift stroke treatment is critical, so when a stroke patient arrives at an emergency room, specialists from across hospital departments -- EMS, neurologists, pharmacists, physicians, nurses, radiologists and technicians -- rush to coordinate a team response. AHA and ASA guidelines, or "best practices," put specific limits on how much time can optimally elapse between the onset of ischemic stroke, in which blood flow to the brain is blocked, and subsequent events like arrival at the hospital and delivery of an infusion. However, experts have questioned whether the communication of those best practices helps medical teams that assemble temporarily and whose members don't typically collaborate. A Journal of Operations Management paper by WVU John Chambers College of Business and Economics associate professor Bernardo Quiroga and coauthors answers that question using data about more than 8,000 patients who received stroke care at a large hospital (not WVU Hospitals) between 2009 and 2017. "'Time is brain' for stroke victims," Quiroga explained. "Blocked blood flow to the brain kills almost two million neurons a minute, so your life or ability to walk or talk hinges on how quickly multiple professionals coordinate to restore blood flow. If you're lucky, you're treated within the first hour of symptom onset. Better yet, you receive a shot of Tissue Plasminogen Activator, which dissolves clots. TPA works better the earlier it's given and usually isn't effective after 4.5 hours." In 2010, the AHA and ASA launched Target: Stroke, a program that identifies stroke care best practices and standardizes each step in the process. Participating hospitals reduced median treatment times from 79 minutes in 2009 to 51 minutes in 2017, but it wasn't clear if that improvement was driven by adherence to best practices or by clinicians learning through repetition as they handled more stroke cases. To figure that out, the researchers investigated whether repeated "learning by doing" decreased the hospital's stroke care time. Then, they evaluated whether deliberate, "induced" learning and implementation of AHA/ASA best practices decreased the time further. Learning through repetition worked. The more strokes the hospital treated, the faster it responded. For each doubling of cumulative stroke alerts, "door-to-needle time" -- the time to get patients from the hospital door to a TPA infusion -- decreased by 10.2%. Best practices also worked. Specifically, the researchers examined two best practices: the Helsinki Model protocol, which directs that EMS staff keep stroke patients on the stretcher for transport to the CT room rather than transferring them to ER beds; and the Rapid Administration of TPA protocol, which requires the pharmacist to be in the CT room with TPA before completion of the CT scan. Those protocols significantly reduced the hospital's door-to-needle time beyond improvements from repetition-based learning. According to Quiroga's coauthor and former PhD student Brandon Lee, that matters because it demonstrates the efficacy of best practices and shows ad hoc teams learning guidelines and implementing them long-term. However, Lee emphasized the importance of the presence of the hospital's stroke advisory committee, which set targets, evaluated stroke teams' performances and gave feedback. Without similar "countermeasures to organizational forgetting," Quiroga acknowledged that best practices aren't always sustainable, especially on ad hoc teams. "In the case of the best practice indicated by the Helsinki Model, compliance is difficult because the hospital needs to coordinate with multiple independent EMS systems. Some EMS providers may be reluctant to commit resources to extended time in the CT room, and EMS staff turnover may lead to forgetting," Quiroga said. Lee added, "Overall, because ad hoc teams are fluid, information sharing is harder. And when a group of people don't know each other well, group learning slows. But although ad hoc teams learn more slowly, we determined they still learn." The research also assessed whether neurologists' abilities to meet time goals were affected by their recent experiences treating prior stroke patients. "As team leaders, neurologists can have an outsized influence on performance," Quiroga said. "Because other members of the ad hoc team aren't familiar with each other, they lean on their leader." But data showed stroke teams improving response times regardless of how many stroke cases the neurologist had treated individually or what the neurologist's recent success rate was. Quiroga said that's good news. "The implication is that learning and sustaining best practices ensures an even quality of care for patients, regardless of individual neurologists' experience levels."

AHA

20 Jun 2024

·www.drugs.com

Reteplase Superior to Alteplase Within 4.5 Hours of Ischemic Stroke

THURSDAY, June 20, 2024 -- Reteplase is noninferior to alteplase for patients with ischemic stroke within 4.5 hours after symptom onset, according to a study published online June 14 in the New England Journal of Medicine to coincide with the 10th Annual Conference of the Chinese Stroke Association & Tiantan International Stroke Conference 2024, held from June 14 to 16 in Beijing. Shuya Li, M.D., from Beijing Tiantan Hospital, and colleagues randomly assigned patients with ischemic stroke within 4.5 hours after symptom onset to receive intravenous reteplase (bolus of 18 mg followed by a second bolus of 18 g 30 minutes later) or intravenous alteplase (0.9 mg/kg body weight up to a maximum of 90 mg; 707 and 705 patients, respectively). The researchers found that 79.5 and 70.4 percent of patients in the reteplase and alteplase groups, respectively, had an excellent functional outcome (risk ratio, 1.13; 95 percent confidence interval, 1.05 to 1.21; P < 0.001 for noninferiority and P = 0.002 for superiority). Symptomatic intracranial hemorrhage within 36 hours after disease onset occurred in 2.4 and 2.0 percent of patients in the reteplase and alteplase groups, respectively (risk ratio, 1.21; 95 percent confidence interval, 0.54 to 2.75). The incidence of any intracranial hemorrhage at 90 days was 7.7 versus 4.4 percent with reteplase versus alteplase (risk ratio, 1.59; 95 percent confidence interval, 1.00 to 2.51), and the incidence of adverse events was 91.6 versus 82.4 percent (risk ratio, 1.11; 95 percent confidence interval, 1.03 to 1.20). "The RAISE trial showed that intravenous reteplase was noninferior to intravenous alteplase in achieving an excellent functional outcome," the authors write. The study was funded by China Resources Angde Biotech Pharma.

Clinical Result

100 Deals associated with Alteplase

External Link

KEGG	Wiki	ATC	Drug Bank
D02837	Alteplase	B01AD02 S01XA13	DB00009

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Myocardial Infarction	JP	Mitsubishi Tanabe Pharma Corp.	29 Mar 1991
Myocardial Infarction	JP	Kyowa Kirin Co., Ltd.	29 Mar 1991
Stroke	JP	Kyowa Kirin Co., Ltd.	29 Mar 1991
Stroke	JP	Mitsubishi Tanabe Pharma Corp.	29 Mar 1991
Acute Ischemic Stroke	US	Genentech, Inc.	13 Nov 1987
Acute myocardial infarction	US	Genentech, Inc.	13 Nov 1987
Pulmonary Embolism	US	Genentech, Inc.	13 Nov 1987

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
COVID-19	Phase 3	AT	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	BE	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	BR	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	FR	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	DE	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	IN	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	IT	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	MY	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	MX	Boehringer Ingelheim GmbH	16 Dec 2020
COVID-19	Phase 3	NL	Boehringer Ingelheim GmbH	16 Dec 2020

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT01827046 (MISTIE-III, Pubmed)	Phase 3	Cerebral Hemorrhage	499	Minimally Invasive Surgery plus Alteplase (MIS+alteplase)	muayidrsry(evkwwifqfe): P-Value = 0.007 View more	Negative	26 Apr 2024
				alteplase
NCT04640194 (CTgov)	Phase 2/3	COVID-19 \| Respiratory Distress Syndrome, Acute	104	Standard of care+Alteplase low dose (Part 1: Alteplase Low Dose)	wjrricaihg(lflyyrmxwn) = omrljnhmte fovvvbjlyj (xugmbjwtlt, sufoekqwsa - atsgitoxyh) View more	-	07 Mar 2024
				Standard of care+Alteplase high dose (Part 1: Alteplase High Dose)	wjrricaihg(lflyyrmxwn) = drhfrwllbd fovvvbjlyj (xugmbjwtlt, cpyjubqwes - ekemlzolkf) View more
NCT03889249 (AcT trial, Pubmed)	Phase 3	Acute Ischemic Stroke	1,577	Alteplase	tzerlxrvle(ekbjotnhwp) = ktmlrtokrp kodixtuniy (yvmfuhbztd ) View more	Positive	01 Feb 2024
				Tenecteplase	tzerlxrvle(ekbjotnhwp) = afnwqkfctc kodixtuniy (yvmfuhbztd ) View more
DEVT and RESCUE BT (ISC2023)	Not Applicable	Acute Ischemic Stroke	467	EVT-alone	khwadawbji(pmahjqnbgy): adjusted RR = 1.12 (95% CI, 0.92 - 1.36), P-Value = 0.27	-	01 Feb 2023
				tirofiban+EVT
ISC2023	Not Applicable	Acute Ischemic Stroke	-	Intravenous Alteplase	tbujoazuuw(cgsklxjfja) = kwvcbubyyr kdyrjfsyzx (cprqwpixvy )	-	01 Feb 2023
ISC2023	Not Applicable	-	191	Tenecteplase	drywcnxayv(jjcuoxspmr) = ctlelinuta wjzvgelbiv (vyavdfnwgw ) View more	-	01 Feb 2023
				Alteplase	drywcnxayv(jjcuoxspmr) = ufrxjysmmc wjzvgelbiv (vyavdfnwgw ) View more
WAKE-UP Trial (Pubmed)	Not Applicable	Stroke	490	Intravenous alteplase	ugscxvmjda(szemxmztap): mean difference = 7.6 (95% CI, 3.9 - 11.8) View more	-	27 Oct 2022
				Placebo
STAR Study (AAO2022)	Not Applicable	Hemorrhage	-	Surgery (vitrectomy with tissue plasminogen activator [TPA], gas tamponade and VEGF inhibitor)	xffoqweipr(okkguueftu) = ybheqfqdrn nvrmgyqfsu (cjboyvbmty, 8.7 - 24.9)	Negative	02 Oct 2022
				Pneumatic displacement with intravitreal injections of gas, TPA and VEGF inhibitor	xffoqweipr(okkguueftu) = itckfrayip nvrmgyqfsu (cjboyvbmty, 7.1 - 25.7)
ERS2022	Not Applicable	Empyema	7	Alteplase	diatnsxhhs(eggqwwhijr) = iqzbezjlpw evvdpzxrvt (qvnbsrxnex ) View more	Positive	04 Sep 2022
				Alteplase	diatnsxhhs(eggqwwhijr) = fsmvysspws evvdpzxrvt (qvnbsrxnex ) View more

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