Review article
EFFICACY AND SAFETY OF LOW-DOSE VERSUS STANDARD-DOSE ALTEPLASE REGIMENS IN PATIENTS WITH ACUTE ISCHAEMIC STROKE
Ranko Škrbić
; Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Zoran Vujković
; Clinic for Neurology, University of Clinical Centre of Republic of Srpska, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Miloš P. Stojiljković
; Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Radoslav Gajanin
; Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Dubravko Bokonjić
; Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Jasmin Komić
; Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia & Herzegovina
Abstract
Background: The use of intravenous recombinant tissue plasminogen activator, alteplase, at a dose of 0.9 mg/kg is an effective
treatment for patients with acute ischaemic stroke; this dose is also associated with high intracerebral haemorrhage rates. The aim of this study was to evaluate whether the low-dose alteplase treatment is as effective and safe as the standard-dose regimen.
Subjects and methods: This was a retrospective, single-centre study, and data were collected from the Hospital Stroke Registry. Based on the severity of stroke and the risk of intracerebral haemorrhage, patients were divided into two groups according to the alteplase doses given; the low-dose (0.6 mg/kg) group (n=45) and the standard-dose (0.9 mg/kg) group (n=165). Ninety-day outcomes measured as modified Rankin score and National Institute for Health Stroke Scale (NIHSS) score, as well as symptomatic intracerebral haemorrhage and mortality rates were analysed.
Results: The standard-dose group had a slightly more favourable outcome (Rankin score 0-2) at 90 days after alteplase treatment than the low-dose group (64.24% vs. 53.33%), but the difference was not significant. The total intracerebral haemorrhage rate and mortality rate at 90 days were higher in the standard-dose group than in the low-dose group (21.2% vs. 13.3% and 6.1% vs. 0.0%, respectively), but these differences were not statistically significant.
Conclusion: The low-dose alteplase treatment applied to the patients with high intracerebral haemorrhage risk had comparable efficacy and safety profile to the standard-dose regimen.
Keywords
acute ischaemic stroke; thrombolytic therapy; alteplase; low-dose; intracerebral haemorrhage
Hrčak ID:
262695
URI
Publication date:
4.4.2019.
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