Thrombolytic therapy for acute ischemic stroke with a lower than standard dose of intravenous alteplase may improve recovery. It may also reduce the risk of intracerebral haemorrhage. This randomised control trial compared low dose intravenous alteplaste (0.6 mg per kilogram of body weight) or the standard dose (0.9mg per kilogram). Outcomes measured considered included the modified Rankin scale score to measure the degree of disability as well as mortality and intracerebral haemorrhage. The trial did not show the noninferiority of low dose alteplaste to standard dose alteplaste with respect to death and disability at ninety days. There were significantly fewer sympotomatic intracerebral hemorrhages with the low dose.
This study was published in the New England Journal of Medicine 16th June 2016, volume 374 number 24 pages 2313-23. It is available in the healthcare library on Level D of the hospital. You can view a full abstract or if you have a personal subscription the full text via this link.