Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial
<p>Abstract</p> <p>Backgrounds</p> <p>Urokinase (UK) 2 200 U/kg·h for 12 hours infusion(UK-12 h)is an ACCP recommended regimen in treating acute pulmonary embolism (PE). It is unclear whether this dose and time can be reduced further. We compared the efficacy and safety...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2009-12-01
|
| Series: | Respiratory Research |
| Online Access: | http://respiratory-research.com/content/10/1/128 |
| _version_ | 1818346633467789312 |
|---|---|
| author | Huang Kewu Dai Huaping Liang Lirong Cheng Zhaozhong Yuan Yadong Yang Yuanhua Zhai Zhenguo Wang Chen Lu Weixuan Zhang Zhonghe Cheng Xiansheng Shen Ying H |
| author_facet | Huang Kewu Dai Huaping Liang Lirong Cheng Zhaozhong Yuan Yadong Yang Yuanhua Zhai Zhenguo Wang Chen Lu Weixuan Zhang Zhonghe Cheng Xiansheng Shen Ying H |
| author_sort | Huang Kewu |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Backgrounds</p> <p>Urokinase (UK) 2 200 U/kg·h for 12 hours infusion(UK-12 h)is an ACCP recommended regimen in treating acute pulmonary embolism (PE). It is unclear whether this dose and time can be reduced further. We compared the efficacy and safety of 20, 000 U/kg for 2 hours (UK-2 h) with the UK-12 h regime in selected PE patients.</p> <p>Methods</p> <p>A randomized trial involving 129 patients was conducted. Patients with acute PE were randomly assigned to receive either UK-12 h (n = 70), or UK-2 h (n = 59). The efficacy was determined by the improvement of right heart dysfunction and perfusion defect at 24 h and 14 d post UK treatment. The bleeding incidence, death rate and PE recurrence were also evaluated.</p> <p>Results</p> <p>Similarly significant improvements in right heart dysfunction and lung perfusion defects were observed in both groups. Overall bleeding incidents were low in both groups. Major bleeding directly associated with UK infusion occurred in one patient in the UK-2 h group and one in the UK-12 h group. Mortality rates were low, with one reported fatal recurrent in the UK-12 h group and none in the UK-2 h group. When the rate of bleeding, death and PE recurrence were compared separately in the hemodynamic instability and the massive anatomic obstruction subgroups, no significant difference was found.</p> <p>Conclusions</p> <p>The UK-2 h regimen exhibits similar efficacy and safety as the UK-12 h regimen for acute PE.</p> <p>Trial Registration</p> <p>Clinical trial registered with <url>http://clinicaltrials.gov/ct2/show/NCT00799968</url> (Identifier: NCT 00799968)</p> |
| first_indexed | 2024-12-13T17:21:22Z |
| format | Article |
| id | doaj.art-933a873be74f49559f423e7f354ff26b |
| institution | Directory Open Access Journal |
| issn | 1465-9921 |
| language | English |
| last_indexed | 2024-12-13T17:21:22Z |
| publishDate | 2009-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-933a873be74f49559f423e7f354ff26b2022-12-21T23:37:17ZengBMCRespiratory Research1465-99212009-12-0110112810.1186/1465-9921-10-128Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trialHuang KewuDai HuapingLiang LirongCheng ZhaozhongYuan YadongYang YuanhuaZhai ZhenguoWang ChenLu WeixuanZhang ZhongheCheng XianshengShen Ying H<p>Abstract</p> <p>Backgrounds</p> <p>Urokinase (UK) 2 200 U/kg·h for 12 hours infusion(UK-12 h)is an ACCP recommended regimen in treating acute pulmonary embolism (PE). It is unclear whether this dose and time can be reduced further. We compared the efficacy and safety of 20, 000 U/kg for 2 hours (UK-2 h) with the UK-12 h regime in selected PE patients.</p> <p>Methods</p> <p>A randomized trial involving 129 patients was conducted. Patients with acute PE were randomly assigned to receive either UK-12 h (n = 70), or UK-2 h (n = 59). The efficacy was determined by the improvement of right heart dysfunction and perfusion defect at 24 h and 14 d post UK treatment. The bleeding incidence, death rate and PE recurrence were also evaluated.</p> <p>Results</p> <p>Similarly significant improvements in right heart dysfunction and lung perfusion defects were observed in both groups. Overall bleeding incidents were low in both groups. Major bleeding directly associated with UK infusion occurred in one patient in the UK-2 h group and one in the UK-12 h group. Mortality rates were low, with one reported fatal recurrent in the UK-12 h group and none in the UK-2 h group. When the rate of bleeding, death and PE recurrence were compared separately in the hemodynamic instability and the massive anatomic obstruction subgroups, no significant difference was found.</p> <p>Conclusions</p> <p>The UK-2 h regimen exhibits similar efficacy and safety as the UK-12 h regimen for acute PE.</p> <p>Trial Registration</p> <p>Clinical trial registered with <url>http://clinicaltrials.gov/ct2/show/NCT00799968</url> (Identifier: NCT 00799968)</p>http://respiratory-research.com/content/10/1/128 |
| spellingShingle | Huang Kewu Dai Huaping Liang Lirong Cheng Zhaozhong Yuan Yadong Yang Yuanhua Zhai Zhenguo Wang Chen Lu Weixuan Zhang Zhonghe Cheng Xiansheng Shen Ying H Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial Respiratory Research |
| title | Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial |
| title_full | Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial |
| title_fullStr | Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial |
| title_full_unstemmed | Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial |
| title_short | Efficacy and safety of 2-hour urokinase regime in acute pulmonary embolism: a randomized controlled trial |
| title_sort | efficacy and safety of 2 hour urokinase regime in acute pulmonary embolism a randomized controlled trial |
| url | http://respiratory-research.com/content/10/1/128 |
| work_keys_str_mv | AT huangkewu efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT daihuaping efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT lianglirong efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT chengzhaozhong efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT yuanyadong efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT yangyuanhua efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT zhaizhenguo efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT wangchen efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT luweixuan efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT zhangzhonghe efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT chengxiansheng efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial AT shenyingh efficacyandsafetyof2hoururokinaseregimeinacutepulmonaryembolismarandomizedcontrolledtrial |