| Title: |
Alteplase in COVID-19 severe hypoxemic respiratory failure: the TRISTARDS multicenter randomized trial |
| Authors: |
Landoni, Giovanni; Chowdary, Pratima; Meziani, Ferhat; Creteur, Jacques; De Schryver, Nicolas; Motsch, Johann; Henrichmoeller, Ingrid; Pagès, Alain; Peter, Nuala; Danays, Thierry; Weigand, Markus A.; the TRISTARDS Investigators; Zoufaly, Alexander; Seitz, Tamara; Pawelka, Erich; Neuhold, Stephanie; Höpler, Wolfgang; Rumpf, Benedikt; Totschnig, David; Likar, Rudolf; Koestenverger, Markus; Neuwersch-Sommeregger, Stefan; Ego, Amedee; Moreau, Anthony; Grimaldi, David; Annoni, Filippo; Gorham, Julie; Halenarova, Katarina; Pletschette, Zoe; Brasseur, Alexandre; Taccone, Fabio; Nobile, Leda; Lheureux, Olivier; Snacken, Morgane; Dehout, Charles; Vinetti, Marco; Serck, Nicolas; Dugernier, Thierry; Layios, Nathalie; Parzibut, Gilles; Boldo, Rodrigo; dos Santos, Vanessa Santos; Nunes, Cristine Erdmann; Diehl, Jean-Luc; Aissaoui, N; Augy, J; Guerot, E; Hauw-Berlemont, C; Hermann, B; Peron, N; Santi, F; Langlais, J; Troger, A; Chekhrit, K; Poissy, Julien; Caplan, M; El Kalioubie, A; Favory, R; Gaudet, A; Goutay, J; Preau, S; Rouze, A; Mariller, Laure; Mira, Jean-Paul; Hamou, Z Ait; Ghanem, S Ben; Bertrix, M; Charpentier, J; Creutin, T; Jozwiak, M; Laghlam, D; Peju, E; Pene, F; Vigneron, C; Demisselle, J; Helms, J; Jandeaux, L; Kummerlen, C; Merdji, H; Monnier, A; Rahmani, H; Studer, A; Cunat, S; Hakkari, Ouafa; Monnet, Xavier; Adda, I; Anguel, N; Ayed, S; Fosse, Q; Guerin, L; Osman, D; Pavot, A; Pham, T; Carpentier, C; Denormandie, P; Lai, C; Fourreau, Alain; Monchi, Mehran; Ellrodt, O; Jochmans, S; Mazerand, S; Rolin, N; Serbource-Goguel, J; Soulier, P; Sy, O; Benane, Nourdine; Mourvillier, Bruno; Cousson, J; Goury, A; Passouant, O; Thery, G; Castex, Cédric; Lascarrou, Jean-Baptiste; Roquilly, A; Canet, E; Garret, C; Lemarie, J; Martin, M; Reignier, J; Seguin, A; Zambon, O; Lamouche Wilquin, P; Agbakou, M; Decamps, P; Desmedt, L; Blonz, G; Hourmant, Y; Grillot, N; Rouhani, A; Bouras, M; Mahe, P.-J.; Latte, D. Demeure Dit; Bourdiol, A; Benkalfate, N; Carpentier, M; Guillotin, F; Benguerfi, S; Zimmermann, Johannes; Al Halabi, Karam; Altvater, Marc; Decker, Sebastian; Fiedler, Mascha; Knebel, Phillip; Maichle, Barbara; Weigand, Markus; Welte, Tobias; Drick, Nora; Pink, Isabelle; Schmidt, Julius Johannes; Bercker, Sven; Simon, Philipp; Fichtner, Falk; Hempel, Gunther; Kliem, Peter; Kluba, Karsten; Laudi, Sven; Müller, Sarah; Oesemann, Rene; Roedel, Michael; Schering, Stefan; Schulz, Sebastian; Seeber, Christian; Ullmann, Hannah; Ziganshyna, Svitlana; Jahn, Nora; Boerge, Bastian; Keller, Maren; Irlbeck, Michael; Frank, Sandra; Hoffmann, Ursula; Huseynov, Aydin; Britsch, Simone; Ishar-Singh, Gill; Jabbour, Claude; Stieglitz, Sven; Guelker, Jan-Erik; Cecconi, Maurizio; Greco, Massimiliano; Monti, Giacomo; Azzolini, Maria Luisa; Righetti, Beatrice; Diaz, Francisco Marquez; Girón, Sofía Elizabeth; de La Cruz, Alejandra Aviles; Ibarra, Ana Elena Ramírez; Romo, Paola Hernández; García, Marián Serna; Castillo, Andrés García; Spronk, Peter; Kuindersma, Marnix; Blans, Michiel; Leeuwen, Henk; Peters, Marco; Rengers, Els; Hoiting, Oscar; Filimonov, Viktor Borisovich; Peshenniokva, Maria; Kravchenko, Olga; Karev, Yuri; Filimonova, Anastasiia; Avdeev, Sergey Nikolaevich; Chikina, Svetlana; Gneusheva, Tatiana; Merzhoeva, Zamira; Nekludova, Galina; Protsenko, Denis Nikolaevich; Tyurin, Igor; Matyushkov, Nikita; Lisun, Tatiana Valerievna V.; Boyarkov, Aleksandr; Bobkova, Svetlana; Klinov, Alexey; Schukarev, Dmitry; Smolin, Nikolay; Ferrer, Ricard; Nuvials, Xavier; Contreras, Sofia; Cortés, Alejandro; Lora, Mariel Rojas; Sierra, Rafael; Alarbe, Samer; Fernandez, Ana; Contreras, Mario; Freire, María Dolores; Revuelto, Jaume; Celaya, Mikel; Marín, Judith; Parrilla, Francisco; Perez, Purificación; Muñoz, Rosana; Diaz, Emilio; Mora, Cristina; de Haro, Candelaria; Moglia, Edgard |
| Source: |
http://lobid.org/resources/99370674133506441#!, 14(1):170. |
| Publication Year: |
2024 |
| Collection: |
Publisso (ZB MED-Publikationsportal Lebenswissenschaften) |
| Subject Terms: |
COVID-19; ARDS; Research; Thrombolysis; Severe hypoxemic respiratory failure; Alteplase |
| Description: |
Abstract Background Pulmonary intravascular thrombus formation has been widely observed in patients with respiratory failure, for example, in patients with SARS-CoV-2 infection (COVID-19). The aim of this study was to evaluate the efficacy/safety of alteplase thrombolysis in COVID-19 severe hypoxemic respiratory failure. In this multicenter, open-label study, patients were randomized to receive alteplase (low- or high-dose) over 5 days plus standard of care (SOC), or SOC alone. The primary endpoint was time to clinical improvement (≥ 2-point decrease on WHO Clinical Progression Scale, or hospital discharge) up to Day 28. Secondary endpoints included all-cause mortality at Day 28, treatment failure at Day 28 and change in arterial oxygen partial pressure/fractional inspired oxygen (PaO2/FiO2) ratio at Day 6 versus baseline. Results Sixty-nine patients were randomized to alteplase (low- or high-dose) and 35 to SOC; 65% were on high-flow oxygen or non-invasive ventilation at baseline. Median time to clinical improvement was 25 days in the alteplase group and > 28 days (median not reached) in the SOC group. All-cause mortality was 8/69 (12%) versus 10/35 (29%) in the alteplase versus SOC groups, respectively (unadjusted risk difference [RD], − 17% [95% confidence interval (CI) − 34 to 0], p = 0.047; adjusted RD, − 16% [95% CI − 31 to 1], p = 0.058). The PaO2/FiO2 ratio (mean [standard deviation]) increased by + 30 (84) mmHg in the alteplase group and decreased by − 12 (59) mmHg in the SOC group (adjusted mean difference vs. SOC, p = 0.052). Differences were greater in patients receiving high-dose alteplase, and in those not receiving invasive ventilation. Eighteen patients (26.1%) in ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISBN: |
978-9937-0-6741-6; 9937-0-6741-3 |
| Relation: |
https://repository.publisso.de/resource/frl:6504005; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551089/ |
| DOI: |
10.1186/s13613-024-01386-z |
| Availability: |
https://repository.publisso.de/resource/frl:6504005; https://doi.org/10.1186/s13613-024-01386-z; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551089/ |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.8F95559C |
| Database: |
BASE |