The mean age of patients of reteplase
group was 56.
is a recombinant non-glycosylated form of human tPA produced in Escherichia coli (E.
In this project, the Q-sepharose Fast Flow was used for separation and purification of reteplase
Efficacy and adverse effects of reteplase
were examined in what is known as the Rapid and Gusto studies (Smalling et al.
was chosen as an alternative to urokinase due to its successful use in thrombolysis of arteriovenous grafts performed by the interventional radiologist to whom the dialysis center referred (Gibbens, DePalma, Albanese, Castner, & Troilo, 2000).
, which also has a high molecular weight, is used to treat acute MI and is not teratogenic in animals, but in rats and rabbits was an abortifacient.
Of the three trials, perhaps the most prominent was the GUSTO (Global Use of strategies to Open Occluded Arteries) V study which involved 16,588 patients and compared heparin plus a full, bolus dose of the thrombolytic reteplase
with a half-dose of reteplase
plus abciximab plus heparin.
Summarizing the Thrombolytic Trial Results Trial Drugs GUSTO V Full-dose reteplase
plus 16,588 unfractionated heparin OR patients Half-dose reteplase
plus abciximab plus unfractionated heparin HERO-2 Streptokinase plus 17,073 unfractionated heparin OR patients Streptokinase plus bivalirudin ASSENT-3 Full-dose tenecteplase plus 6,095 unfractionated heparin OR patients Full-dose tenecteplase plus enoxaparin OR Half-dose tenecteplase plus half-dose abciximab plus unfractionated heparin Trial Outcomes GUSTO V Adding abciximab cut the 16,588 repeat MI rate.
Bolus thrombolytic agents like reteplase
are available and much better suited than tissue plasminogen activator for use in the prehospital arena.
The 16,600 acute MI patients in the trial are being randomly assigned to conventional full-dose reteplase
or to half-dose reteplase
plus full-dose therapy with abciximab.