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

摘要

The standard dose of recombinant tissue-type plas-nminogen activator (rt-PA; alteplase) for pulmo-nnary embolism (PE) treatment is 100 mg. In this issue nof CHEST (see page 254 ), Wang and colleagues, n 1 n nreporting a multicenter clinical trial from China, ncompare that dose with a dose of 50 mg. They conclude nthat the effi cacy of 50 mg rt-PA was similar, and for npatients weighing , 65 kg with BMI , 25, bleeding nwas reduced. Their recommendation to use 50 mg nfor patients , 65 kg appears solidly grounded, but nuptake should be cautious, for the usual reasons.