Trial reportStroke2015
Combined Approach to Lysis Utilizing Eptifibatide and Recombinant Tissue-Type Plasminogen Activator in Acute Ischemic Stroke-Full Dose Regimen Stroke Trial.
Registry-linked trialAbstract readClinical TrialMulticenter Study
In one paragraph
Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01977456 (Phase 2 The Combined Approach to Lysis Utilizing Eptifibatide and Rt-PA in Acute Ischemic Stroke-Full Dose Regimen), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase 2 The Combined Approach to Lysis Utilizing Eptifibatide and Rt-PA in Acute Ischemic Stroke-Full Dose Regimen(CLEAR-FDR)
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Chinese Stroke Association scientific statement: intravenous thrombolysis in acute ischaemic stroke.Stroke and vascular neurology · 2017Guideline
- Adjunctive Intravenous Argatroban or Eptifibatide for Ischemic Stroke.The New England journal of medicine · 2024Trial
- Randomized, Multicenter Trial of ARTSS-2 (Argatroban With Recombinant Tissue Plasminogen Activator for Acute Stroke).Stroke · 2017Trial
- Intravenous Argatroban or Eptifibatide in Patients Undergoing Mechanical Thrombectomy: A Subgroup Analysis of the MOST Randomized Clinical Trial.JAMA neurology · 2025Article
- Adjunctive Antithrombotic Medications to Acute Reperfusion Therapy: Current Evidence and Future Directions.Stroke · 2025Review
- Dual-responsive and NIR-triggered detachable nanoplatform for integrated thrombolytic and antiplatelet therapy.Asian journal of pharmaceutical sciences · 2025Article
- Drip and ship in patients with acute ischemic stroke: a narrative review.Therapeutic advances in neurological disorders · 2025Review
- Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice.International journal of molecular sciences · 2023Review
- Antiplatelet Use in Ischemic Stroke.The Annals of pharmacotherapy · 2022Review
- Improving treatment for acute ischemic stroke-Clot busting innovation in the pipeline.Frontiers in medical technology · 2022Article
- Endovascular Treatment of Large Vessel Occlusion Strokes Due to Intracranial Atherosclerotic Disease.Journal of stroke · 2022Review
- The multiarm optimization of stroke thrombolysis phase 3 acute stroke randomized clinical trial: Rationale and methods.International journal of stroke : official journal of the International Stroke Society · 2021Article
- European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke.European stroke journal · 2021Article
- Safety of Low Dose Intravenous Cangrelor in Acute Ischemic Stroke: A Case Series.Frontiers in neurology · 2021Article
- Benefit and risk of early intravenous heparin after thrombolysis in patients with acute ischemic stroke.Brain and behavior · 2020Article
- Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture.Journal of thrombosis and thrombolysis · 2020Article
- Role of the Platelets and Nitric Oxide Biotransformation in Ischemic Stroke: A Translative Review from Bench to Bedside.Oxidative medicine and cellular longevity · 2020Review
- Probing the Effective Treatment Thresholds for Alteplase in Acute Ischemic Stroke With Regression Discontinuity Designs.Frontiers in neurology · 2020Article
- Review
- Early ST-segment elevation acute myocardial infarction after thrombolytic therapy for acute ischemic stroke: A case report.Medicine · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Opeolu AdeoyeFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.). Opeolu.Adeoye@uc.edu.
Heidi SucharewFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Jane KhouryFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Achala VagalFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Pamela A SchmitFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Irene EwingFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Steven R LevineFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Stacie DemelFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Bryan EckerleFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Brian KatzFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Dawn KleindorferFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Brian StettlerFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Daniel WooFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Pooja KhatriFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Joseph P BroderickFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Arthur M PancioliFrom the University of Cincinnati Neuroscience Institute, OH (O.A., P.A.S., I.E., S.D., B.E., B.K., D.K., B.S., D.W., P.K., J.P.B., A.M.P.); Departments of Emergency Medicine (P.A.S., I.E., B.S., A.M.P.), Neurosurgery (O.A.), Radiology (A.V.), and Neurology (S.D., B.E., B.K., D.K., D.W., P.K., J.P.B.), University of Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, OH (H.S., J.K.); and Departments of Neurology and Emergency Medicine, The State University of New York (SUNY) Downstate Stroke Center and Medical Center, and King County Hospital Center, Brooklyn, NY (S.R.L.).
Funding
LCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5MTHE RELATIONSHIP OF SERUM PROTEINS TO STROKE SEVERITYP50NS044283 · NINDS · UNIVERSITY OF CINCINNATI · PI BRODERICK, JOSEPH PAUL · 2002 to 2012
$17.1MCerebrovascular Fellowship Training ProgramT32NS047996 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Stacie Demel · 2006 to 2026
$3.7MNCATS NIH HHS UL1 TR001425NINDS NIH HHS P50 NS044283NINDS NIH HHS T32 NS047996
Abstract
background and purposeThe Combined Approach to Lysis Utilizing Eptifibatide and Recombinant Tissue-Type Plasminogen Activator (r-tPA; CLEAR) in Acute Ischemic Stroke (AIS) and CLEAR-Enhanced Regimen (CLEAR-ER) trials demonstrated safety of reduced dose r-tPA plus the glycoprotein 2b/3a inhibitor, eptifibatide, in AIS compared with r-tPA alone. The objective of the CLEAR-Full Dose Regimen (CLEAR-FDR) trial was to estimate the rate of symptomatic intracerebral hemorrhage (sICH) in AIS patients treated with the combination of full-dose r-tPA plus eptifibatide.
methodsCLEAR-FDR was a single-arm, prospective, open-label, multisite study. Patients aged 18 to 85 years treated with 0.9 mg/kg IV r-tPA within 3 hours of symptom onset were enrolled. After obtaining consent, eptifibatide (135 μg/kg bolus and 2-hour infusion at 0.75 μg/kg per minute) was administered. The primary end point was the proportion of patients who experienced sICH within 36 hours. An independent clinical monitor adjudicated if an sICH had occurred and an independent neuroradiologist reviewed all images. The stopping rule was 3 sICHs within the first 19 patients or 4 sICHs within 29 patients.
resultsFrom October 2013 to December 2014, 27 patients with AIS were enrolled. Median age was 73 years (range, 34-85; interquartile range, 65-80) and median National Institute of Health stroke scale score was 12 (range, 6-26; interquartile range, 9-16). One sICH (3.7%; 95% confidence interval, 0.7%-18%) was observed.
conclusionsThese results demonstrate comparable safety of full-dose r-tPA plus eptifibatide with historical rates of sICH with r-tPA alone and support proceeding with a phase 3 trial evaluating full-dose r-tPA combined with eptifibatide to improve outcomes after AIS.
Indexed as
AdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageDrug Therapy, CombinationEptifibatideFemaleFibrinolytic AgentsHumansMaleMiddle AgedPeptidesPlatelet Aggregation InhibitorsStrokeThrombolytic TherapyEptifibatideFibrinolytic AgentsPeptidesPlatelet Aggregation InhibitorsTissue Plasminogen Activatorclinical trialeptifibatidestroketissue-type plasminogen activator
Identifiers
What OpenQuestion holds
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Registered trials
NCT01977456ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.