A comparison of low- versus standard-dose bridging alteplase in acute ischemic stroke mechanical thrombectomy using indirect methods.
acute ischemic stroke
bridging alteplase therapy
dose
indirect comparisons
mechanical thrombectomy
Journal
Therapeutic advances in neurological disorders
ISSN: 1756-2856
Titre abrégé: Ther Adv Neurol Disord
Pays: England
ID NLM: 101480242
Informations de publication
Date de publication:
2023
2023
Historique:
received:
22
09
2022
accepted:
25
11
2022
entrez:
6
2
2023
pubmed:
7
2
2023
medline:
7
2
2023
Statut:
epublish
Résumé
Whether low-dose alteplase is similar to standard-dose bridging alteplase prior to endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS) remains uncertain. The aim of this study was to compare the efficacy and safety outcomes of low- versus standard-dose bridging alteplase therapy (BT) in patients with acute ischemic stroke (AIS) who are eligible for intravenous thrombolysis (IVT) within 4.5 h after onset. We conducted an indirect comparison of low- We included six RCTs of 2334 AIS patients in this analysis, including one trial using low-dose bridging alteplase ( Indirect evidence shows that the effects of low- and standard-dose bridging alteplase are similar for key efficacy and safety outcomes. Due to the wide confidence intervals, larger randomized trials comparing low- and standard-dose alteplase bridging therapy are required.
Sections du résumé
Background
UNASSIGNED
Whether low-dose alteplase is similar to standard-dose bridging alteplase prior to endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS) remains uncertain.
Aims
UNASSIGNED
The aim of this study was to compare the efficacy and safety outcomes of low- versus standard-dose bridging alteplase therapy (BT) in patients with acute ischemic stroke (AIS) who are eligible for intravenous thrombolysis (IVT) within 4.5 h after onset.
Methods
UNASSIGNED
We conducted an indirect comparison of low-
Results
UNASSIGNED
We included six RCTs of 2334 AIS patients in this analysis, including one trial using low-dose bridging alteplase (
Conclusion
UNASSIGNED
Indirect evidence shows that the effects of low- and standard-dose bridging alteplase are similar for key efficacy and safety outcomes. Due to the wide confidence intervals, larger randomized trials comparing low- and standard-dose alteplase bridging therapy are required.
Identifiants
pubmed: 36741353
doi: 10.1177/17562864221144806
pii: 10.1177_17562864221144806
pmc: PMC9896089
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
17562864221144806Informations de copyright
© The Author(s), 2023.
Déclaration de conflit d'intérêts
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Eur Stroke J. 2021 Mar;6(1):I-LXII
pubmed: 33817340
Curr Neurovasc Res. 2018;15(3):204-210
pubmed: 30014803
N Engl J Med. 2020 May 21;382(21):1981-1993
pubmed: 32374959
World Neurosurg. 2019 Jan;121:e154-e158
pubmed: 30244073
J Thromb Thrombolysis. 2021 Feb;51(2):536-544
pubmed: 32918671
N Engl J Med. 2021 Nov 11;385(20):1833-1844
pubmed: 34758251
BMJ. 2016 Apr 18;353:i1754
pubmed: 27091337
Stat Med. 2002 Jun 15;21(11):1575-600
pubmed: 12111921
J Neurointerv Surg. 2022 Mar;14(3):209
pubmed: 35115395
J Am Coll Cardiol. 2012 Aug 21;60(8):738-46
pubmed: 22575324
Front Neurol. 2021 Apr 09;12:653820
pubmed: 33897607
Lancet. 2016 Apr 23;387(10029):1723-31
pubmed: 26898852
JAMA. 2021 Jan 19;325(3):234-243
pubmed: 33464335
J Neuroimaging. 2011 Apr;21(2):113-20
pubmed: 19909396
Surg Neurol Int. 2020 Nov 06;11:374
pubmed: 33408908
Health Technol Assess. 2005 Jul;9(26):1-134, iii-iv
pubmed: 16014203
Neurology. 2021 Mar 16;96(11):e1512-e1526
pubmed: 33536271
J Stroke. 2018 Jan;20(1):131-139
pubmed: 29402064
J Clin Epidemiol. 1997 Jun;50(6):683-91
pubmed: 9250266
Dtsch Arztebl Int. 2015 Nov 20;112(47):803-8
pubmed: 26634940
JAMA. 2021 Jan 19;325(3):244-253
pubmed: 33464334
Neurol Sci. 2022 Oct;43(10):5993-6002
pubmed: 35764896
Cerebrovasc Dis. 2012;34(2):106-14
pubmed: 22868870
BMJ. 2009 Apr 03;338:b1147
pubmed: 19346285
Lancet. 2022 Jul 9;400(10346):104-115
pubmed: 35810756
Lancet Neurol. 2018 Jan;17(1):47-53
pubmed: 29263006
Lancet. 2022 Jul 9;400(10346):116-125
pubmed: 35810757
Stroke. 2010 May;41(5):885-90
pubmed: 20224056
N Engl J Med. 2016 Jun 16;374(24):2313-23
pubmed: 27161018
Medicina (Kaunas). 2020 Jul 17;56(7):
pubmed: 32708971
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037