Accelerated alteplase regimens - more studies warranted PHARMACOLOGY Although a patency rate >85% was not achieved 90 min after the administration of accelerated dose regimens of alteplase in 219 patients with acute myocardial infarction (MI), an early patency rate of approximately 85% was approached. Of the 5 regimens studied, the highest 90-min patency rate (83%) was achieved with a regimen of IV alteplase 0.75 mg/kg infused over 30 mins (10% given as a bolus) followed by 0.5 mgjkg infused over 60 mins. Reocclusion rates were low with these accelerated dose regimens compared with conventional 3-hour dosing regimens, and bleeding complications were comparable to those seen with conventional regimens. These findings suggest that 'accelerated rt-PA [alteplaseJ therapy deserves more extensive investigation'. It is thought that by achieving higher levels of thrombolytics as early as possible, the chances of, and the rate of, reperfusion will be improved. Results of this study conducted by Dr TC Wall and colleagues from USA showed that it is possible to achieve high levels of alteplase within 30 minutes of initiating accelerated dose regimens. Wall TC, Califf RM, George BS, TAMP study group, et al. Accelerated plasminogen activator dose regimens for coronary thrombolysis. Journal of the American College of Cardiology 19: 482- 489, I Mar 1992 994' lSSN 0156·2703/92/0328'()()21 /$1.00/0 © Ads hdllrnaliclllDllld 2L INPHARMA e 28 Mar 1992

Accelerated alteplase regimens - more studies warranted

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Accelerated alteplase regimens - more studies warranted

PHARMACOLOGY

Although a patency rate >85% was not achieved 90 min after the administration of accelerated dose regimens of alteplase in 219 patients with acute myocardial infarction (MI), an early patency rate of approximately 85% was approached. Of the 5 regimens studied, the highest 90-min patency rate (83%) was achieved with a regimen of IV alteplase 0.75 mg/kg infused over 30 mins (10% given as a bolus) followed by 0.5 mgjkg infused over 60 mins.

Reocclusion rates were low with these accelerated dose regimens compared with conventional 3-hour dosing regimens, and bleeding complications were comparable to those seen with conventional regimens. These findings suggest that 'accelerated rt-PA [alteplaseJ therapy deserves more extensive investigation'.

It is thought that by achieving higher levels of thrombolytics as early as possible, the chances of, and the rate of, reperfusion will be improved. Results of this study conducted by Dr TC Wall and colleagues from USA showed that it is possible to achieve high levels of alteplase within 30 minutes of initiating accelerated dose regimens. Wall TC, Califf RM, George BS, TAMP study group, et al. Accelerated plasminogen activator dose regimens for coronary thrombolysis. Journal of the American College of Cardiology 19: 482-489, I Mar 1992 994'

lSSN 0156·2703/92/0328'()()21 /$1.00/0 © Ads hdllrnaliclllDllld

INPHARMA e 28 Mar 1992