Comparative Safety and Efficacy of Urokinase and Recombinant Tissue Plasminogen Activator for Peripheral Arterial Occlusion: A Meta-Analysis

Authors

  • Stephen Sander Pharm.D.,

    1. Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut
    2. Departments of Pharmacy Services and Cardiology, Hartford Hospital, Hartford, Connecticut
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  • C. Michael White Pharm.D.,

    1. Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut
    2. Departments of Pharmacy Services and Cardiology, Hartford Hospital, Hartford, Connecticut
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  • Craig I. Coleman Pharm.D.

    Corresponding author
    1. Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, Connecticut
    2. Departments of Pharmacy Services and Cardiology, Hartford Hospital, Hartford, Connecticut
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Pharmacoeconomics and Outcomes Studies Group, Hartford Hospital, 80 Seymour Street, CB 309, Hartford, CT 06102; e-mail: ccolema@harthosp.org.

Abstract

Study Objective. To evaluate differences in the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) and urokinase in the treatment of peripheral arterial occlusion.

Design. Systematic review and meta-analysis of prospective comparative trials.

Data Source. PubMed/MEDLINE database from 1966-October 2004.

Conclusion. Urokinase was less effective than rt-PA in successfully lysing acute peripheral arterial occlusion, but it was associated with lower rates of total and minor bleeding. Overall, rt-PA was a reasonable substitute for urokinase, now that urokinase has been removed from the market in the United States. However, judicious monitoring for minor bleeding is necessary

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