Guidelines for the Intravenous Application of Recombinant Tissue-type Plasminogen Activator (Alteplase), the Second Edition, October 2012: A Guideline from the Japan Stroke Society

Kazuo Minematsu, Kazunori Toyoda, Teruyuki Hirano, Kazumi Kimura, Rei Kondo, Etsuro Mori, Jyoji Nakagawara, Nobuyuki Sakai, Yoshiaki Shiokawa, Norio Tanahashi, Masahiro Yasaka, Yasuo Katayama, Susumu Miyamoto, Akira Ogawa, Makoto Sasaki, Sadao Suga, Takenori Yamaguchi

Research output: Contribution to journalArticlepeer-review

98 Citations (Scopus)

Abstract

In Japan, intravenous alteplase, a recombinant tissue-type plasminogen activator (rt-PA), was approved for an indication of ischemic stroke in 2005 on the basis of the results of a clinical trial with a unique dose of the drug (0.6 mg/kg). The Japan Stroke Society published the guidelines for intravenous application of rt-PA and organized training sessions for proper use all over Japan in an effort to promote the safe, widespread use of intravenous alteplase. Seven years following its approval, clinical experience with intravenous alteplase has accumulated, additional evidence of intravenous alteplase has been found in Japan and overseas, and the medical environment has substantially changed, including approvals for new drugs and medical devices. Notably, the use of alteplase in the extended therapeutic time window (within 4.5 hours of symptom onset) became covered by insurance in Japan in August 2012. To address these changing situations, we have decided to prepare the revised guidelines. In preparing the second edition, we took care to make its contents more practical by emphasizing information needed in clinical practice. While the first edition was developed with emphasis on safety in light of limited clinical experience with intravenous alteplase in Japan in 2005, this second edition is a substantial revision of the first edition mainly in terms of eligibility criteria, on the basis of accumulated evidence and the clinical experience.

Original languageEnglish
Pages (from-to)571-600
Number of pages30
JournalJournal of Stroke and Cerebrovascular Diseases
Volume22
Issue number5
DOIs
Publication statusPublished - 2013 Jul

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Guidelines for the Intravenous Application of Recombinant Tissue-type Plasminogen Activator (Alteplase), the Second Edition, October 2012: A Guideline from the Japan Stroke Society'. Together they form a unique fingerprint.

Cite this