Prourokinase Shows No Advantage Over Standard Care for Mild Ischemic Stroke: PUMICE Trial Findings
China: A recent randomized clinical trial, the PUMICE study, evaluated the efficacy and safety of prourokinase compared to standard care in patients with mild ischemic stroke. Findings of the trial, published in JAMA Neurology, indicate that prourokinase did not outperform standard care in enhancing functional outcomes for patients with mild ischemic stroke treated within 4.5 hours of symptom onset, although its safety profile was comparable.
Trials to date have not established the superiority of alteplase or tenecteplase over standard care in patients with mild ischemic stroke, while also raising concerns about their safety profiles. In this context, prourokinase emerges as a potential alternative fibrinolytic agent that may offer a more favorable safety profile. However, the benefit-risk profile of prourokinase in the treatment of mild stroke remains unclear. To address this gap, Yunyun Xiong, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, and colleagues aimed to evaluate the efficacy and safety of prourokinase in patients with mild ischemic stroke when administered within 4.5 hours of symptom onset.
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