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How to establish the outer limits of reperfusion therapy
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(2021) How to establish the outer limits of reperfusion therapy. Stroke, 52 (10). pp. 3399-3403. doi:10.1161/STROKEAHA.121.035022 ISSN 0039-2499.
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Official URL: https://doi.org/10.1161/STROKEAHA.121.035022
Abstract
Reperfusion therapy with intravenous alteplase and endovascular therapy are effective treatments for selected patients with acute ischemic stroke. Guidelines for treatment are based upon randomized trials demonstrating substantial treatment effects for highly selected patients based on time from stroke onset and imaging features. However, patients beyond the current established guidelines might benefit with lesser but still clinically significant treatment effects. The STAIR (Stroke Treatment Academic Industry Roundtable) XI meeting convened a workgroup to consider the “outer limits” of reperfusion therapy by defining the current boundaries, and exploring optimal parameters and methodology for determining the outer limits. In addition to statistical significance, the minimum clinically important difference should be considered in exploring the limits of reperfusion therapy. Societal factors and quality of life considerations should be incorporated into assessment of treatment efficacy. The threshold for perception of benefit in the medical community may differ from that necessary for the Food and Drug Administration approval. Data from alternative sources such as platform trials, registries and large pragmatic trials should supplement randomized controlled trials to improve generalizability to routine clinical practice. Further interactions between industry and academic centers should be encouraged.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RB Pathology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||
| Library of Congress Subject Headings (LCSH): | Reperfusion (Physiology), Cerebrovascular disease -- Treatment | ||||||
| Journal or Publication Title: | Stroke | ||||||
| Publisher: | Lippincott Williams & Wilkins | ||||||
| ISSN: | 0039-2499 | ||||||
| Official Date: | 2 September 2021 | ||||||
| Dates: |
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| Volume: | 52 | ||||||
| Number: | 10 | ||||||
| Page Range: | pp. 3399-3403 | ||||||
| DOI: | 10.1161/STROKEAHA.121.035022 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Copyright Holders: | © 2021 American Heart Association, Inc. | ||||||
| Description: | Special Report |
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| Date of first compliant deposit: | 13 September 2021 | ||||||
| Date of first compliant Open Access: | 2 March 2022 |
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