Evidence map›Paper›PMID 33297893›Full record

ArticleInternational journal of stroke : official journal of the International Stroke Society2021

The multiarm optimization of stroke thrombolysis phase 3 acute stroke randomized clinical trial: Rationale and methods.

S Iris Deeds, Andrew Barreto, Jordan Elm, Colin P Derdeyn, Scott Berry, Pooja Khatri, Claudia Moy, Scott Janis, Joseph Broderick, James Grotta and 1 more

Open access · greenAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of stroke : official journal of the International Stroke Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
3.3field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. Efficacy and safety of endovascular treatment with or without intravenous alteplase in acute anterior circulation large vessel occlusion stroke: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
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  17. Hyperacute ischemic stroke care-Current treatment and future directions.International journal of stroke : official journal of the International Stroke Society · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 1 country.

S Iris DeedsDepartment of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA.ORCID 0000-0001-6788-0071
Andrew BarretoDepartment of Neurology, University of Texas Health Science Center, Houston, TX, USA.
Jordan ElmData Coordination Unit, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Colin P DerdeynDepartment of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Scott BerryBerry Consultants, LLC., Austin, TX, USA.
Pooja KhatriDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH, USA.
Claudia Moy35046National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Scott Janis35046National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Joseph BroderickDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH, USA.
James GrottaMemorial Hermann Hospital - Texas Medical Center, Houston, TX, USA.
Opeolu AdeoyeDepartment of Emergency Medicine, University of Cincinnati, Cincinnati, OH, USA.
University of Cincinnati · USNational Institute of Neurological Disorders and Stroke · USBerry & Associates (United States) · USMedical University of South Carolina · USMemorial Hermann · USThe University of Texas Health Science Center at Houston · USUniversity of Iowa Hospitals and Clinics · US

Funding

NSTN National Clinical Coordinating CenterU01NS086872 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Pooja Khatri · 2013 to 2026
$32.3M
Multi-arm Optimization of Stroke Thrombolysis (MOST) Stroke TrialU01NS100699 · NINDS · WASHINGTON UNIVERSITY · PI ADEOYE, OPEOLU M, BARRETO, ANDREW D · 2018 to 2021
$18.8M
NINDS NIH HHS U01 NS086872NINDS NIH HHS U01 NS100699
6 · The paper itself

Abstract

backgroundIntravenous recombinant tissue plasminogen activator is the only proven effective medication for the treatment of acute ischemic stroke. Two approaches that may augment recombinant tissue plasminogen activator thrombolysis and prevent arterial reocclusion are direct thrombin inhibition with argatroban and inhibition of the glycoprotein 2b/3a receptor with eptifibatide.

aimThe multi-arm optimization of stroke thrombolysis trial aims to determine the safety and efficacy of intravenous therapy with argatroban or eptifibatide as compared with placebo in acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator within 3 h of symptom onset. SAMPLE SIZE ESTIMATE: A maximum of 1200 randomized subjects to test the superiority of argatroban or eptifibatide to placebo in improving 90-day modified Rankin scores. METHODS AND

designMultiarm optimization of stroke thrombolysis is a multicenter, multiarm, adaptive, single blind, randomized controlled phase 3 clinical trial conducted within the National Institutes of Health StrokeNet clinical trial network. Patients treated with 0.9 mg/kg intravenous recombinant tissue plasminogen activator within 3 h of stroke symptom onset are randomized to receive intravenous argatroban (100 µg/kg bolus followed by 3 µg/kg/min for 12 h), intravenous eptifibatide (135 µg/kg bolus followed by 0.75 µg/kg/min infusion for 2 h) or IV placebo. Patients may receive endovascular thrombectomy per usual care. STUDY OUTCOMES: The primary efficacy outcome is improved modified Rankin score assessed at 90 days post-randomization. DISCUSSION: Multiarm optimization of stroke thrombolysis is an innovative and collaborative project that is the culmination of many years of dedicated efforts to improve outcomes for stroke patients.

Indexed as

Brain IschemiaStrokeClinical Trials, Phase III as TopicFibrinolytic AgentsHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicSingle-Blind MethodThrombolytic TherapyTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen ActivatorAcute ischemic strokealteplase recombinant tissue plasminogen activatorargatrobanclinical trialeptifibatiderecanalizationrecombinant tissue plasminogen activator

Identifiers

PMID33297893
PMCPMC8926066
OpenAlexW3110910172

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.