Update on intravenous tissue plasminogen activator for acute stroke: from clinical trials to clinical practice

Tissue plasminogen activator (tPA) injected intravenously within 3 hours of symptom onset has emerged as a treatment option for acute ischemic stroke. Although controversial and not universally accepted, its use in carefully selected patients is supported by evidence from randomized controlled trial...

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Bibliographic Details
Published inCanadian Medical Association journal (CMAJ) Vol. 165; no. 3; pp. 311 - 317
Main Authors Gladstone, D J, Black, S E
Format Journal Article
LanguageEnglish
Published Canada CMA Impact, Inc 07.08.2001
Subjects
Acute Disease
Clinical Trials, Phase III as Topic
Clinical Trials, Phase IV as Topic
Fibrinolytic Agents - therapeutic use
Humans
Injections, Intravenous
Review
Stroke
Stroke - drug therapy
Tissue Plasminogen Activator - therapeutic use
Treatment
Treatment Outcome
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Summary:Tissue plasminogen activator (tPA) injected intravenously within 3 hours of symptom onset has emerged as a treatment option for acute ischemic stroke. Although controversial and not universally accepted, its use in carefully selected patients is supported by evidence from randomized controlled trials and by mounting community experience. In this paper we review the literature published in the past 5 years regarding the safety, clinical trial efficacy and real-world effectiveness of intravenous tPA for stroke. First we review data from the phase III clinical trials on which approval for tPA is based. Then we summarize a growing literature of postmarketing phase IV studies and discuss the limitations and challenges that lie ahead. Our aim is to provide clinicians with an overview of this evolving therapy.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0820-3946
1488-2329