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Desmoteplase for Acute Ischemic Stroke within 3 to 9   Hours after Symptom Onset: Evidence from Randomized Controlled Trials

View Article: PubMed Central - PubMed

ABSTRACT

Recent studies have shown inconsistent results regarding the value of desmoteplase for treating acute ischemic stroke (AIS) when administered within an extended time window. We performed a meta-analysis to explore the value of desmoteplase in AIS treatment. The MEDLINE, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) that had evaluated desmoteplase versus placebo for AIS. The primary outcomes were intracranial hemorrhage (ICH) within 72 hours and favorable outcome at Day 90. We pooled 819 patients from 5 RCTs. Desmoteplase treatment showed a neutral effect on favorable outcome (P = 0.42) but a favorable safety profile in terms of ICH (P = 0.64) compared with the placebo group. In the subgroup analysis, 90 μg/kg desmoteplase, a late time to treatment (6–9 hours), and serious stroke symptoms at baseline (NIHSS > 12) subgroups showed high risks of ICH (P ≤ 0.02). A high dose of desmoteplase (125 μg/kg) showed a tendency to improve recanalization (P = 0.05), but was also associated with an increased risk of death (P = 0.04). In conclusion, desmoteplase administered over an extended time window had no significant effect on functional recovery but exhibited a favorable safety profile in patients with AIS.

No MeSH data available.


Risk of bias: A summary table for each risk of bias item for each study.
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Related In: Results  -  Collection

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f4: Risk of bias: A summary table for each risk of bias item for each study.

Mentions: Details about the risks of bias of the included studies are shown in Fig. 4. Three trials did not give details about the blinding of outcome assessments (detection bias). Two trials lacked a detailed explanation of side effects, which might have led to high risks of incomplete outcome data (attrition bias).


Desmoteplase for Acute Ischemic Stroke within 3 to 9   Hours after Symptom Onset: Evidence from Randomized Controlled Trials
Risk of bias: A summary table for each risk of bias item for each study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037417&req=5

f4: Risk of bias: A summary table for each risk of bias item for each study.
Mentions: Details about the risks of bias of the included studies are shown in Fig. 4. Three trials did not give details about the blinding of outcome assessments (detection bias). Two trials lacked a detailed explanation of side effects, which might have led to high risks of incomplete outcome data (attrition bias).

View Article: PubMed Central - PubMed

ABSTRACT

Recent studies have shown inconsistent results regarding the value of desmoteplase for treating acute ischemic stroke (AIS) when administered within an extended time window. We performed a meta-analysis to explore the value of desmoteplase in AIS treatment. The MEDLINE, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) that had evaluated desmoteplase versus placebo for AIS. The primary outcomes were intracranial hemorrhage (ICH) within 72 hours and favorable outcome at Day 90. We pooled 819 patients from 5 RCTs. Desmoteplase treatment showed a neutral effect on favorable outcome (P = 0.42) but a favorable safety profile in terms of ICH (P = 0.64) compared with the placebo group. In the subgroup analysis, 90 μg/kg desmoteplase, a late time to treatment (6–9 hours), and serious stroke symptoms at baseline (NIHSS > 12) subgroups showed high risks of ICH (P ≤ 0.02). A high dose of desmoteplase (125 μg/kg) showed a tendency to improve recanalization (P = 0.05), but was also associated with an increased risk of death (P = 0.04). In conclusion, desmoteplase administered over an extended time window had no significant effect on functional recovery but exhibited a favorable safety profile in patients with AIS.

No MeSH data available.