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Half the Dosage, Similar Efficacy, Less Bleeding: The New Tissue Plasminogen Activator Regimen for Pulmonary Embolism?

Bruce L. Davidson, MD, MPH, FCCP; for the China Venous Thromboembolism (VTE) Study Group
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine.

Correspondence to: Bruce L. Davidson, MD, MPH, FCCP, Clinical Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, 1952 Tenth Ave W, Seattle WA 98119; e-mail: brucedavidson@pobox.com


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Davidson has accepted honoraria for participation in clinical research of new anticoagulants and hemostatic drugs from Bayer, Portola, Boehringer-Ingelheim, and CSL Behring. He has no relationship with any maker of thrombolytic drugs or devices.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(2):245-247. doi:10.1378/chest.09-2156
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Extract

The standard dose of recombinant tissue-type plasminogen activator (rt-PA; alteplase) for pulmonary embolism (PE) treatment is 100 mg. In this issue of CHEST (see page 254 ), Wang and colleagues,1 reporting a multicenter clinical trial from China, compare that dose with a dose of 50 mg. They conclude that the efficacy of 50 mg rt-PA was similar, and for patients weighing <65 kg with BMI <25, bleeding was reduced. Their recommendation to use 50 mg for patients <65 kg appears solidly grounded, but uptake should be cautious, for the usual reasons.

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