Thrombolysis in the developing world: is there a role for streptokinase?
(2013) In International Journal of Stroke 8(7). p.560-565- Abstract
- Intravenous thrombolysis with tissue plasminogen activator is the only proven acute therapy for ischemic stroke. This therapy has not been translated into clinical practice in the developing world primarily due to economic constraints. Streptokinase, a lower cost alternative thrombolytic agent, is widely available in developing countries where it is utilized to treat patients with acute coronary syndromes. Although this drug has previously been found to be ineffective in ischemic stroke, the lack of benefit may have been related to a number of factors related to trial design rather than the drug itself. Specific features of prior trial designs that may have adversely affected outcomes include a prolonged treatment window, inclusion of... (More)
- Intravenous thrombolysis with tissue plasminogen activator is the only proven acute therapy for ischemic stroke. This therapy has not been translated into clinical practice in the developing world primarily due to economic constraints. Streptokinase, a lower cost alternative thrombolytic agent, is widely available in developing countries where it is utilized to treat patients with acute coronary syndromes. Although this drug has previously been found to be ineffective in ischemic stroke, the lack of benefit may have been related to a number of factors related to trial design rather than the drug itself. Specific features of prior trial designs that may have adversely affected outcomes include a prolonged treatment window, inclusion of patients with established infarction on computed tomography scan, failure to treat excessive arterial pressures, a fixed dose of streptokinase, and concomitant use of antithrombotic medications. Given the lack of therapeutic alternatives in developing countries, a new trial of streptokinase in acute stroke, utilizing stricter inclusion criteria similar to those in more recent thrombolytic studies, appears warranted. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4212889
- author
- Butcher, Ken ; Shuaib, Ashfaq ; Saver, Jeffrey ; Donnan, Geoffrey ; Davis, Stephen M. ; Norrving, Bo LU ; Wong, K. S. Lawrence ; Abd-Allah, Foad ; Bhatia, Rohit and Khan, Adnan
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute stroke therapy, clinical trial, cost factors, developing, countries, ischemic stroke, thrombolysis
- in
- International Journal of Stroke
- volume
- 8
- issue
- 7
- pages
- 560 - 565
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000324333700021
- scopus:84884332329
- pmid:23336290
- ISSN
- 1747-4949
- DOI
- 10.1111/j.1747-4949.2012.00923.x
- language
- English
- LU publication?
- yes
- id
- 5d94e332-9be1-497e-b47f-c4e34631f56c (old id 4212889)
- date added to LUP
- 2016-04-01 10:15:36
- date last changed
- 2022-01-25 21:28:08
@article{5d94e332-9be1-497e-b47f-c4e34631f56c,
abstract = {{Intravenous thrombolysis with tissue plasminogen activator is the only proven acute therapy for ischemic stroke. This therapy has not been translated into clinical practice in the developing world primarily due to economic constraints. Streptokinase, a lower cost alternative thrombolytic agent, is widely available in developing countries where it is utilized to treat patients with acute coronary syndromes. Although this drug has previously been found to be ineffective in ischemic stroke, the lack of benefit may have been related to a number of factors related to trial design rather than the drug itself. Specific features of prior trial designs that may have adversely affected outcomes include a prolonged treatment window, inclusion of patients with established infarction on computed tomography scan, failure to treat excessive arterial pressures, a fixed dose of streptokinase, and concomitant use of antithrombotic medications. Given the lack of therapeutic alternatives in developing countries, a new trial of streptokinase in acute stroke, utilizing stricter inclusion criteria similar to those in more recent thrombolytic studies, appears warranted.}},
author = {{Butcher, Ken and Shuaib, Ashfaq and Saver, Jeffrey and Donnan, Geoffrey and Davis, Stephen M. and Norrving, Bo and Wong, K. S. Lawrence and Abd-Allah, Foad and Bhatia, Rohit and Khan, Adnan}},
issn = {{1747-4949}},
keywords = {{acute stroke therapy; clinical trial; cost factors; developing; countries; ischemic stroke; thrombolysis}},
language = {{eng}},
number = {{7}},
pages = {{560--565}},
publisher = {{Wiley-Blackwell}},
series = {{International Journal of Stroke}},
title = {{Thrombolysis in the developing world: is there a role for streptokinase?}},
url = {{http://dx.doi.org/10.1111/j.1747-4949.2012.00923.x}},
doi = {{10.1111/j.1747-4949.2012.00923.x}},
volume = {{8}},
year = {{2013}},
}