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Reanalysis of alteplase for stroke stirs controversy

New York Jeanne Lenzer

An independent panel, appointed by a leading US institute to reanalyse the data regarding stroke treatment, has published its findings which they say support the use of thrombolytic agent alteplase (tPA, also known as rt-PA) "to treat patients with acute ischaemic stroke within three hours of onset under the NINDS [National Institute of Neurological Disorders and Stroke] tPA trial protocol."

Data was reanalysed after an article in the BMJ (2002;324:723-9) sparked off controversy. The original study data reviewed by the panel was published in the New England Journal of Medicine more than nine years ago (1995;333:1581-7).

Critics take issue, however, with the printed conclusions of the analysis published in this month’s issue of Stroke (2004;35:2418-24).

Jerome Hoffman, professor of medicine and emergency medicine at the University of California in Los Angeles and a leading critic of calls for widespread use of thrombolysis for stroke, said, "I’m . . . [Full text of this article]

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Related Article

Alteplase for stroke: money and optimistic claims buttress the "brain attack" campaign • Commentary: Who pays the guideline writers? • Commentary: Thrombolysis in stroke: it works!

Jeanne Lenzer, Charles Warlow, Jeffrey L Saver, Chelsea S Kidwell, and Sidney Starkman
BMJ 2002 324: 723-729. [Extract] [Full Text] [PDF]

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Rapid Responses:

Read all Rapid Responses

The NINDS Reanalysis Committee analysed the NINDS trial from the wrong perspective

Jeffrey Mann
bmj.com, 8 Oct 2004 [Full text]