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Effect of IV Thrombolysis With Alteplase in Patients With Vessel Occlusion in the WAKE-UP Trial.
Neurology
January 2025
From the Center for Stroke Research Berlin (I.G., J.B.F.), Charité-Universitätsmedizin Berlin, Germany; Service de Biostatistique (F.B., P.R.), Hospices Civils de Lyon, France; Department of Neurology (B.C., C.G., G.T.), University Medical Center Hamburg-Eppendorf, France; Department of Stroke Medicine (T.-H.C.), Université Claude Bernard Lyon 1, Hospices Civils de Lyon, France; Neurologie der Rehaklinik Medical Park Humboldtmühle (M. Ebinger), Berlin; Klinik und Hochschulambulanz für Neurologie (M. Endres), Charité-Universitätsmedizin Berlin; Center for Stroke Research Berlin (M. Endres); German Center for Neurodegenerative Diseases (DZNE), partner site Berlin (M. Endres); German Centre for Cardiovascular Research (DZHK), partner site Berlin (M. Endres); German Center for Mental Health (DZPG), partner site Berlin (M. Endres), Germany; Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Diagnostic and Interventional Neuroradiology (J.F.), Universitätsklinikum Hamburg-Eppendorf, Germany; Robertson Centre for Biostatistics (I.F.), University of Glasgow, Scotland; mediri GmbH (J.G.); Fraunhofer Institute for Digital Medicine MEVIS (M.G.), Bremen, Germany; Department of Neurosciences (R.L., A.W.), Experimental Neurology, KU Leuven-University of Leuven, Belgium; School of Psychology & Neuroscience (K.W.M.), University of Glasgow, Scotland; Department of Stroke Medicine (N.N.), Université Claude Bernard Lyon 1, and Hospices Civils de Lyon, France; Department of Neurology (C.Z.S.), Aarhus University Hospital, Denmark; Florey Institute of Neuroscience and Mental Health (V.N.T.), Heidelberg, Australia; and Institut d'Investigació Biomèdica de Girona (S.P.), Hospital Universitari Doctor Josep Trueta, Girona, Spain.
Background And Objectives: Data from randomized trials on the treatment effect of pure thrombolysis in patients with vessel occlusion are lacking. We examined data from a corresponding subsample of patients from the multicenter, randomized, placebo-controlled WAKE-UP trial to determine whether MRI-guided IV thrombolysis with alteplase in unknown-onset ischemic stroke benefits patients presenting with vessel occlusion.
Methods: Patients with an acute ischemic lesion visible on MRI diffusion-weighted imaging but no marked parenchymal hyperintensity on fluid-attenuated inversion recovery images were randomized to treatment with IV alteplase or placebo.
Factors Influencing Nerinetide Effect on Infarct Volume in Patients Without Alteplase in the Randomized ESCAPE-NA1 Trial.
Stroke
January 2025
Department of Diagnostic Imaging (J.M.O., M.G., B.K.M., M.A.A., A.M.D., M.J., M.D.H.), University of Calgary, Alberta, Canada.
Background: In the ESCAPE-NA1 trial (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischemic Stroke), treatment with nerinetide was associated with a smaller infarct volume among patients who did not receive intravenous alteplase. We assessed the effect of nerinetide on the surrogate imaging outcome of final infarct volume in patients who did not receive intravenous alteplase and explored predictors of outcome and modifiers of nerinetide's effect on infarct volume.
Methods: ESCAPE-NA1 was a multicenter, randomized trial in which patients with acute stroke with a baseline Alberta Stroke Program Early CT Score >4, undergoing endovascular thrombectomy, were randomized to receive intravenous nerinetide or placebo.
Inflammation-Associated Coagulation Reactions are Associated with the Prognosis in Critically Ill Very Old Patients (VOPs) with Infection.
J Inflamm Res
November 2024
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Background: Dysregulated host response is an important cause of critical illness. Coagulation reaction is the most primitive response and can be used to assess patient status. Coagulation reactions may be amplified in very old patients (VOPs).
View Article and Find Full Text PDFAnti-Inflammatory Thrombolytic JX10 (TMS-007) in Late Presentation of Acute Ischemic Stroke.
Stroke
December 2024
Department of Research and Development, TMS Co, Ltd, Fuchu, Japan (N.N., K. Hasegawa, K. Hasumi).
Background: Contemporary thrombolytics in acute ischemic stroke are limited to administration within 4.5 hours of last known normal. JX10 (formerly TMS-007), a triprenyl phenol family member, may extend this therapeutic window.
View Article and Find Full Text PDFTissue Plasminogen Activator or Perfluoropropane for Submacular Hemorrhage in Age-Related Macular Degeneration: A Factorial Randomized Clinical Trial.
JAMA Ophthalmol
December 2024
King's Ophthalmology Research Unit, Ophthalmology Department, King's College Hospital, London, United Kingdom.
Importance: Evidence is limited to support therapies to treat submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (AMD) as an adjunct to anti-vascular endothelial growth factor therapy (anti-VEGF).
Objective: To determine if intravitreal tissue plasminogen activator (TPA) or gas improves visual acuity or promotes resolution of SMH secondary to neovascular AMD in eyes treated with ranibizumab.
Design, Setting, And Participants: This was a double-masked, sham-controlled, factorial randomized clinical trial and feasibility study that recruited participants from June 2014 to March 2019, with 12 months' follow-up.
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