6/28/23, 1:19 AM DUMAS Pathway Feedback Search Clinical Topics Home Studies DUMAS DUMAS Disease Acute ischemic stroke Trial question What is the role of dual thrombolytic therapy with mutant prourokinase and small bolus alteplase in patients with ischemic stroke? Study design Multi-center Open label RCT Population Characteristics of study participants 38.0% female N = 238 62.0% male 238 patients (91 female, 147 male) Inclusion criteria: adult patients with ischemic stroke Key exclusion criteria: eligibility for endovascular thrombectomy; prestroke disability interfering with assessment of functional outcome; pregnancy; contraindication to MRI Interventions N=121 mutant prourokinase (bolus of 5 mg intravenous alteplase and 40 mg intravenous infusion of mutant prourokinase) N=117 alteplase alone (standard treatment with 0.9 mg/kg of intravenous alteplase alone) Primary outcome https://web.pathway.md/studies/reccIhu45i5WWUWGm 1/2 6/28/23, 1:19 AM DUMAS Pathway Any intracranial hemorrhage on neuroimaging at 24 hours 13.7 % 13.7 13.2 10.3 % 6.8 % 3.4 % No significant difference 0.0 % Mutant prourokinase Alteplase alone No significant difference in any intracranial hemorrhage on neuroimaging at 24 hours (13.2% vs. 13.7%; OR 0.98, 95% CI 0.46 to 2.12) Secondary outcomes No significant difference in improvement in NIHSS score at 24 hours (63.6% vs. 70.9%; OR 0.68, 95% CI 0.39 to 1.2) No significant difference in mean ordinal mRS score at day 30 (2 vs. 2; OR 1.16, 95% CI 0.74 to 1.84) No significant difference in mean infarct volume at 24 hours (5.1 mL vs. 7 mL; AD -1.9 mL, 95% CI -3.8 to 0) Safety outcomes No significant differences in death at day 30, serious adverse events. Conclusion In adult patients with ischemic stroke, mutant prourokinase was not superior to alteplase alone with respect to any intracranial hemorrhage on neuroimaging at 24 hours. Reference Nadinda A M van der Ende, Bob Roozenbeek, Lucas E M Smagge et al. Safety and Efficacy of Dual Thrombolytic Therapy With Mutant Prourokinase and Small Bolus Alteplase for Ischemic Stroke. JAMA Neurol. 2023 May 22;e231262. Online ahead of print. Open reference URL https://web.pathway.md/studies/reccIhu45i5WWUWGm 2/2