Saruplase, a new fibrin specific thrombolytic agent; efficacy and safety in the first 1000 patients

Vermeer, Frank; Massberg, I.; Meyer, Jörg; Bär, Frits W.; Michels, Rolf; Tebbe, U; Vanhove, Ph.; Barth, H.; Flohé, Leopold

doi:10.1016/0735-1097(91)91575-y

Cited by 6 publications

(1 citation statement)

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“…The PRIMI study published in 1989 has demonstrated that this drug was more efficient than streptokinase in terms of early coronary patency rate (5). Safety data analyzed by Vermeer et al from a cohort of 1698 patients suffering from a myocardial infarction and treated with saruplase were found to be comparable to what had been previously reported with streptokinase and t-PA (10). This pilot study is the first one to investigate the effects of saruplase in pulmonary embolism.…”

Section: Discussionsupporting

confidence: 75%

Rapid Haemodynamic Improvement Following Saruplase in Recent Massive Pulmonary Embolism

Pacouret

Barnes²,

Hopkins³

et al. 1998

Thromb Haemost

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In a single centre pilot study, saruplase (20 mg bolus plus 60 mg infusion over 1 h) was administered to twenty patients with an angiographically documented recent massive pulmonary embolism: Miller index of at least 20 and mean pulmonary artery pressure of at least 20 mmHg. The lytic ability of saruplase to cause normalization of haemodynamic parameters over the first 12 h and reperfusion of pulmonary arteries at 24 h was assessed. A decrease of 25 ± 10% in total pulmonary resistance was evident at 30 min. Haemodynamic parameters continued to improve with total pulmonary resistance decreasing by 29 ± 8% and 40 ± 11% at 1 and 12 h respectively. Relative improvement in Miller index 24 ± 6 h after saruplase treatment was 38 ± 9%. Two patients suffered recurrent pulmonary embolism, two severe bleeding events were observed. One patient died following a haemorrhagic stroke. Pulmonary AngiographyPulmonary angiography, using a pigtail catheter was performed with brachial venous access. Contrast medium was injected into the main pulmonary trunk in an anteroposterior position. Angiography was performed both prior to lysis and again at 24 ± 6 h. Standard, large format cut film angiograms were produced. The severity of embolism was assessed by the method of Miller et al. (8). The angiograms were initially scored by the treating physician, but on completion of the trial a central analysis, with blinding of the sequence of angio-

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Section: Discussionsupporting

confidence: 75%

Rapid Haemodynamic Improvement Following Saruplase in Recent Massive Pulmonary Embolism

Pacouret

Barnes²,

Hopkins³

et al. 1998

Thromb Haemost

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Ischemic stroke and intracranial hemorrhage following thrombolytic therapy for acute myocardial infarction: A risk-benefit analysis

Sloan

Gore

1992

The American Journal of Cardiology

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Creation of the recombinant tissue plasminogen activator (rt-PA) image and its influence on practice habits

Sherry

Marder

1991

Journal of the American College of Cardiology

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American physicians have commonly practiced thrombolytic therapy for acute myocardial infarction with the recombinant form of tissue plasminogen activator (rt-PA), although its cost is much higher than that of streptokinase. The greater popularity of rt-PA is based on the belief that it is a more effective and a safer drug for achieving myocardial salvage and mortality reduction. However, a series of studies testing this assumption have not substantiated its greater efficacy or safety with respect to not only streptokinase but also urokinase and anisoylated plasminogen-streptokinase activator complex (APSAC). This editorial reviews the sequence of events that led to the creation of the rt-PA image, the mistaken premises on which it was based and the questions that need to be addressed if we are to strengthen the scientific method for evaluating similar types of drugs and its influence on practice habits including the costs to the health system.

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Saruplase, a new fibrin specific thrombolytic agent; efficacy and safety in the first 1000 patients

Cited by 6 publications

References 0 publications

Rapid Haemodynamic Improvement Following Saruplase in Recent Massive Pulmonary Embolism

Rapid Haemodynamic Improvement Following Saruplase in Recent Massive Pulmonary Embolism

Ischemic stroke and intracranial hemorrhage following thrombolytic therapy for acute myocardial infarction: A risk-benefit analysis

Creation of the recombinant tissue plasminogen activator (rt-PA) image and its influence on practice habits

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