Safety and Tolerability of Desmoteplase Within 3 to 9 Hours After Symptoms Onset in Japanese Patients With Ischemic Stroke

• Published in: Stroke (1970) 2015-09, Vol.46 (9), p.2549-2554
• Main Authors: Mori, Etsuro, Minematsu, Kazuo, Nakagawara, Jyoji, Hasegawa, Yasuhiro, Nagahiro, Shinji, Okada, Yasushi, Truelsen, Thomas, Lindsten, Annika, Ogawa, Akira, Yamaguchi, Takenori
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain Ischemia - drug therapy; Constriction, Pathologic - pathology; Female; Fibrinolytic Agents - administration & dosage; Fibrinolytic Agents - adverse effects; Humans; Infarction, Middle Cerebral Artery - pathology; Japan; Male; Middle Aged; Plasminogen Activators - administration & dosage; Plasminogen Activators - adverse effects; Stroke - drug therapy; Thrombolytic Therapy - adverse effects; Thrombolytic Therapy - methods; Treatment Outcome
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.115.009917

BACKGROUND AND PURPOSE—This study investigated the safety and tolerability of desmoteplase administered within 3 to 9 hours after stroke symptoms onset in Japanese patients with acute ischemic stroke. METHODS—Patients were randomized to treatment with either desmoteplase or placebo in a 2:1 ratio in 2 consecutive cohorts (70 μg/kg and then 90 μg/kg). Included patients had a baseline National Institutes of Health Stroke Scale score of 4 to 24 and occlusion or high-grade stenosis in the middle cerebral artery segment M1 or M2 on magnetic resonance angiography. The incidence of symptomatic intracranial hemorrhage (≤72 hours) was defined as the primary end point. The occurrence of asymptomatic ICH, symptomatic cerebral edemas, and adverse events were other safety outcomes of special interest. RESULTS—Symptomatic intracranial hemorrhage was observed within 72 hours in 2 patients treated with placebo and in 1 patient treated with 70 μg/kg desmoteplase. Any ICH (symptomatic or asymptomatic ICH) within 72 hours were observed in 7 (43.8%) patients treated with placebo, in 8 (50%) patients treated with 70 μg/kg desmoteplase, and in 9 (56.3%) patients treated with 90 μg/kg desmoteplase. Desmoteplase treatment with 70 or 90 μg/kg was not associated with an increased risk of symptomatic cerebral edema compared with placebo. There were no other serious safety concerns associated with desmoteplase. CONCLUSIONS—Desmoteplase in both 70 and 90 μg/kg doses had a favorable safety profile and was well tolerated in Japanese patients with acute ischemic stroke when administered 3 to 9 hours after stroke symptoms onset. CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT01104467.