SynthesisMedicine2017
Efficacy and safety of desmoteplase in acute ischemic stroke patients: A systematic review and meta-analysis.
Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review.Frontiers in pharmacology · 2022Pooled it
- Review
- Intravenous Thrombolytics in the Treatment of Acute Ischemic Stroke.Current treatment options in cardiovascular medicine · 2023Review
- Clinical Pharmacokinetics and Pharmacodynamics of Desmoteplase.European journal of drug metabolism and pharmacokinetics · 2022Review
- Silver Jubilee of Stroke Thrombolysis With Alteplase: Evolution of the Therapeutic Window.Frontiers in neurology · 2021Review
- Recanalization Treatment of Acute Ischemic Stroke Caused by Large-Artery Occlusion in the Elderly: A Comparative Analysis of "the Elderly" and "the Very Elderly".Disease markers · 2021Article
- Intracranial Bleeding After Reperfusion Therapy in Acute Ischemic Stroke.Frontiers in neurology · 2020Review
- From Animal Poisons and Venoms to Medicines: Achievements, Challenges and Perspectives in Drug Discovery.Frontiers in pharmacology · 2020Review
- Fibrinolytic Enzymes for Thrombolytic Therapy.Advances in experimental medicine and biology · 2019Review
- Structural Biology and Protein Engineering of Thrombolytics.Computational and structural biotechnology journal · 2019Review
- A Novel Role of VEGFC in Cerebral Ischemia With Lung Injury.Frontiers in neuroscience · 2019Article
- Fourth European stroke science workshop.European stroke journal · 2018Article
- Cerebral Hypoperfusion and Other Shared Brain Pathologies in Ischemic Stroke and Alzheimer's Disease.Translational stroke research · 2018Review
- Targeting von Willebrand Factor in Ischaemic Stroke: Focus on Clinical Evidence.Thrombosis and haemostasis · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPending results from double-blind, multicenter, parallel-group, randomized trials, the benefit and safety of the novel plasminogen activator, desmoteplase remain undetermined. The aim of this meta-analysis was to help evaluate desmoteplase's efficacy and safety.
methodsA thorough search was performed of the Cochrane Library, PubMed, and Embase from the inception of electronic data to March 2017, and double-blind, multicenter, parallel-group, randomized trials were chosen. We conducted a meta-analysis of studies investigating intravenous desmoteplase treatment of acute ischemic stroke patients 3 to 9 hours after symptom onset. Asymptomatic intracerebral hemorrhage, good clinical outcome at 90 days, and reperfusion 4 to 8 hours posttreatment were variables assessing efficacy; symptomatic intracerebral hemorrhage and death rates were measures of safety.
resultsSix trials involving 1071 patients thrombolyzed >3 hours postonset were included (600 received intravenous desmoteplase, 471 placebo). Desmoteplase was associated with increased reperfusion (odds ratio [OR] 1.57; 95% confidence interval [CI], 1.10-2.24; P = .01 vs control) and showed a tendency to increase asymptomatic intracerebral hemorrhage (OR 1.25; 95% CI, 0.97-1.62; P = .09 vs control), whereas there was no increase in symptomatic intracerebral hemorrhage and death rate with desmoteplase. However, there was no difference in the clinical response at 90 days (OR 1.14; 95% CI, 0.88-1.49; P = .31 vs control). Subgroup analysis showed that desmoteplase 90 μg/kg (OR 1.53; 95% CI, 1.07-2.21; P = .02 vs control) and 125 μg/kg (OR 4.07; 95% CI, 1.16-14.24; P = .03 vs control) were associated with an increase in reperfusion. Also, we found desmoteplase 90 μg/kg showed a tendency to increase asymptomatic intracerebral hemorrhage (OR 1.25; 95% CI, 0.95-1.63; P = .11 vs control).
conclusionIntravenous desmoteplase is associated with a favorable reperfusion efficacy and acceptable safety in ischemic stroke treatment >3 hours after symptom onset. Well-designed randomized controlled trials with larger patient cohorts and a moderate dose of drugs are needed to further evaluate the true efficacy of desmoteplase in stroke patients.
trial registrationURL: http://www.crd.york.ac.uk/PROSPERO; PROSPERO registration number: CRD42016037667).
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Registered trials
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.