Document Detail


Alteplase and tenecteplase: applications in the peripheral circulation.
MedLine Citation:
PMID:  11981795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Alteplase (t-PA), a recombinant analogue of human tissue plasminogen activator, became the first genetically engineered thrombolytic approved by the Food and Drug Administration in 1987 for acute myocardial infarction (AMI). In addition to AMI, alteplase is currently approved for the treatment of acute ischemic stroke and pulmonary embolism, and we anticipate approval for catheter clearance in late 2001 in a 2-mg vial configuration. With the withdrawal of human neonatal kidney cell-derived urokinase, alteplase has become an alternative agent in peripheral vascular applications. Because few interventionalists had prior experience with the handling and dosage of alteplase, the Advisory Panel to the Society of Cardiovascular and Interventional Radiology established practice guidelines for use in noncoronary applications. Emerging clinical experience with contemporary dosing regimens shows a safety and efficacy profile similar to urokinase but with significantly reduced drug costs. Tenecteplase (TNK) is a genetically modified version of alteplase. TNK is the only plasminogen activator available that has shown a significantly enhanced safety profile versus alteplase in AMI. Approved for a 5-second, single-bolus injection in AMI, TNK possesses a longer half-life, increased resistance to plasminogen activator inhibitor, and improved fibrin specificity compared with alteplase. Because of its enhanced safety profile, TNK may be a desirable agent for peripheral vascular applications. Initial clinical studies with TNK in acute arterial and venous disease are ongoing. This article outlines the Advisory Panel guidelines for using alteplase and highlights features of tenecteplase.
Authors:
C P Semba; K Sugimoto; M K Razavi;
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Publication Detail:
Type:  Guideline; Journal Article; Practice Guideline; Review    
Journal Detail:
Title:  Techniques in vascular and interventional radiology     Volume:  4     ISSN:  1089-2516     ISO Abbreviation:  Tech Vasc Interv Radiol     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2002-04-30     Completed Date:  2002-06-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9806675     Medline TA:  Tech Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-106     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company
Affiliation:
Cardiovascular Clinical Research, Genentech Inc., MS 59, 1 DNA Way, South San Francisco, CA 94080-4990, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Circulation / drug effects
Dose-Response Relationship, Drug
Fibrinolytic Agents / pharmacology*,  standards,  therapeutic use*
Humans
Thrombolytic Therapy / standards
Tissue Plasminogen Activator / pharmacology*,  standards,  therapeutic use*
Treatment Outcome
United States
United States Food and Drug Administration
Urokinase-Type Plasminogen Activator / pharmacology,  standards,  therapeutic use
Vascular Patency / drug effects
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/tenecteplase; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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