Combinations ofthrombolytics in MI- the way forward? Researchers from the University of Heidelberg in Germany believe that 'streptokinase is relatively ineffective, unselective, antigenic, but cheap' whereas 'recombinant tissue-type plasminogen activator (rt-PA) [alteplaseJ is more effective and selective, but very expensive'. Bode et al. also assert that the combination of thrombolytic agents can produce results that are presently not obtainable with a single agent. Studies to date show that the combination of alteplase and urokinase is of interest because it is associated with a low reocclusion rate. Studies of alteplase combined with saruplase have revealed that this combination has high efficacy and high specificity. Bode et al. believe that this latter combination appears to be the one most suitable for future testing. For more details on combination thrombolytic therapy, see Inpharma 882; 5. /0 Apr 1993. Bode Ch. Baumann H. von Hodenberg E. Nordl T. Combinations of thrombolytic agents in acute myocardial infarction. Zeitschrift fur Kardiologie 82 (Suppl. 2): 125-128. 1993 8002" .... Editorial comment: In previous major trials. alteplase and streptokinase confe"ed an equivalent mortality benefit. while streptokinase was associated with a lower incidence of stroke in GISSI-2 and ISIS-3. To date GUSTO is the only major controlled trial to show greater efficacy of alteplase [see Inpharma 886; 3.8 May 1993J. ISSN 0156-2703/93/0eOHlO171$1.od' Adlalntematlonal Ltd THERAPY 17

Combinations of thrombolytics in MI - the way forward?

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Combinations ofthrombolytics in MIthe way forward?

Researchers from the University of Heidelberg in Germany believe that 'streptokinase is relatively ineffective, unselective, antigenic, but cheap' whereas 'recombinant tissue-type plasminogen activator (rt-PA) [alteplaseJ is more effective and selective, but very expensive'. Bode et al. also assert that the combination of thrombolytic agents can produce results that are presently not obtainable with a single agent.

Studies to date show that the combination of alteplase and urokinase is of interest because it is associated with a low reocclusion rate. Studies of alteplase combined with saruplase have revealed that this combination has high efficacy and high specificity. Bode et al. believe that this latter combination appears to be the one most suitable for future testing. For more details on combination thrombolytic therapy, see Inpharma 882; 5. /0 Apr 1993. Bode Ch. Baumann H. von Hodenberg E. Nordl T. Combinations of thrombolytic agents in acute myocardial infarction. Zeitschrift fur Kardiologie 82 (Suppl. 2): 125-128. 1993 8002" ....

~ Editorial comment: In previous major trials. alteplase and streptokinase confe"ed an equivalent mortality benefit. while streptokinase was associated with a lower incidence of stroke in GISSI-2 and ISIS-3. To date GUSTO is the only major controlled trial to show greater efficacy of alteplase [see Inpharma 886; 3.8 May 1993J.

ISSN 0156-2703/93/0eOHlO171$1.od' Adlalntematlonal Ltd

THERAPY 17