Safety and Efficacy of Dual Thrombolytic Therapy With Mutant Prourokinase and Small Bolus Alteplase for Ischemic Stroke: A Randomized Clinical Trial.,JAMA Neurology

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Safety and Efficacy of Dual Thrombolytic Therapy With Mutant Prourokinase and Small Bolus Alteplase for Ischemic Stroke: A Randomized Clinical Trial.
JAMA Neurology ( IF 20.4 ) Pub Date : 2023-05-22 , DOI: 10.1001/jamaneurol.2023.1262
Nadinda A. M. van der Ende _{1,

2} , Bob Roozenbeek ₁ , Lucas E. M. Smagge ₂ , Sven P. R. Luijten _{1,

2} , Leo A. M. Aerden ₃ , Petra Kraayeveld ₄ , Ido R. van den Wijngaard ₅ , Geert J. Lycklama à Nijeholt ₆ , Heleen M. den Hertog ₇ , H. Zwenneke Flach ₈ , Alida A. Postma ₉ , Stefan D. Roosendaal ₁₀ , G. Menno Krietemeijer ₁₁ , Lonneke S. F. Yo ₁₁ , Moniek P. M. de Maat ₁₂ , Daan Nieboer ₁₃ , Gregory J. Del Zoppo _{14,

15} , William J. Meurer _{16,

17,

18} , Hester F. Lingsma ₁₃ , Aad van der Lugt ₂ , Diederik W. J. Dippel ₁ , Diederik W.J. Dippel ₁₉ , Aad van der Lugt ₁₉ , Nadinda A.M. van der Ende ₁₉ , Bob Roozenbeek ₁₉ , Moniek P.M. de Maat ₁₉ , Leo A.M. Aerden ₁₉ , Ido R. van den Wijngaard ₁₉ , Heleen M. den Hertog ₁₉ , Petra Kraayeveld ₁₉ , Geert J. Lycklama a Nijeholt ₁₉ , H. Zwenneke Flack ₁₉ , Michael D. Hill ₁₉ , Jeremy Rempel ₁₉ , Ann M. Lowe ₁₉ , Hester F. Lingsma ₁₉ , Nikki van Leeuwen ₁₉ , Daan Nieboer ₁₉ , Gregory J. Del Zoppo ₁₉ , Dingeman C. Rijken ₁₉ , Adam Cohen ₁₉ , Victor Gurewich ₁₉ , Lucas E.M. Smagge ₁₉ , Stefan D. Roosendaal ₁₉ , Alida A. Postma ₁₉ , Lonneke S.F. Yo ₁₉ , G. Menno Krietemeijer ₁₉ , Martin Sterrenberg ₁₉ , Naziha El Ghannouti ₁₉ , Debby Priem ₁₉ , Monique Batenburg ₁₉ , Eva Ponjee ₁₉ , Rieke Eilander ₁₉ , Joke de Meris ₁₉ , Tamara Dofferhoff-Vermeulen ₁₉ , Sanne J. den Hartog ₁₉ , Stijn Kremer ₁₉ , Sven P.R. Luijten ₁₉ , Leontien Heiligers ₁₉ , Angela Lansbergen-Engel ₁₉ , Karin Jager ₁₉ ,

Affiliation

Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
Department of Neurology, Reinier de Graaf, Delft, the Netherlands
Department of Radiology and Nuclear Medicine, Reinier de Graaf, Delft, the Netherlands
Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
Department of Radiology and Nuclear Medicine, Haaglanden Medical Center, The Hague, the Netherlands
Department of Neurology, Isala, Zwolle, the Netherlands
Department of Radiology and Nuclear Medicine, Isala, Zwolle, the Netherlands
Department of Radiology and Nuclear Medicine, School for Mental Health and Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
Department of Radiology and Nuclear Medicine, Catharina Hospital, Eindhoven, the Netherlands
Department of Hematology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle
Department of Neurology, University of Washington School of Medicine, Seattle
Departments of Neurology, University of Michigan Medical School, Ann Arbor
Departments of Emergency Medicine, University of Michigan Medical School, Ann Arbor
Berry Consultants, Austin, Texas
for the DUMAS Investigators

Dual thrombolytic treatment with small bolus alteplase and mutant prourokinase has the potential to be a safer and more efficacious treatment for ischemic stroke than alteplase alone because mutant prourokinase is designed to act only on degraded fibrin without affecting circulating fibrinogen.

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