A study evaluating a new approach using a combination of two thrombolytics designed to reduce bleeding risk in patients with acute ischemic stroke has not shown any benefit on the primary outcome of all intracranial hemorrhage (ICH).
However, there were some encouraging findings including a trend towards a reduction in symptomatic ICH, researchers report, and the combination approach did not show any depletion of fibrinogen levels, which suggests a potential lower bleeding risk.
"Although the main results of this study are neutral, we are encouraged that the combination approach with a low dose of alteplase followed by the new mutant pro-urokinase product looked as effective as full dose alteplase alone, and there were some promising signs signaling a potential lower bleeding risk," senior investigator, Diederik Dippel, MD, Erasmus University Medical Center, Rotterdam, Netherlands, told theheart.org | Medscape Cardiology.
The DUMAS study (DUal thrombolytic therapy with Mutant pro-urokinase and low dose Alteplase for ischemic Stroke) was presented at the World Stroke Congress in Singapore on Oct. 28, by study co-author Nadinda van der Ende, MD, also from Erasmus University Medical Center.
She pointed out that thrombolysis with intravenous alteplase increases the likelihood of a good outcome in acute ischemic stroke but can cause symptomatic intracranial hemorrhage, which can be associated with death and major disability.
