Independent panel finds alteplase beneficial for acute stroke patients

A review of an earlier study of the use of alteplase has confirmed that the drug, when given according to the study's protocol, reduced disability in patients with acute stroke.

Kirk Douglas: the United States' most famous stroke sufferer

AARON HARRIS/AP PHOTO

The review was undertaken after a controversy sparked off by an article in the BMJ last year (2002;324: 723-9). The earlier study was published in the New England Journal of Medicine more than seven years ago (1995;333: 1581-7).

The BMJ article said that the original study was cited as the reason why the American Heart Association had changed its guidelines on the use of alteplase but pointed out that most of the association's experts on stroke had ties to the drug's manufacturer. The article provoked numerous letters, many of which pointed to possible weaknesses in the original study.

The new review was carried out by an independent panel set up by the National Institute of Neurological Diseases and Stroke (NINDS), which conducted the trial. The results of the review were announced at the annual meeting of the Society of Academic Emergency Medicine in Boston last week.

The panel, chaired by W Michael O'Fallon, a professor of biostatistics, said that analyses confirmed the trial's finding that alteplase, delivered according to its protocol, reduced disability in patients with acute stroke. …