Abstract
In this study, von Kummer et al present the results of the DIAS-4 trial (Efficacy and Safety Study of Desmoteplase to Treat Acute Ischemic Stroke [phase 4]), as well as results of a pooled analysis from the DIAS-3 and 4 and DIAS-Japan trial. The DIAS trials were double-blind, randomized, placebo-controlled trials testing the safety and efficacy of 90 μg/kg of intravenous desmoteplase administered 3 to 9 hours after symptom onset in patients with occlusion or high-grade stenosis in proximal segments of the middle, anterior, or posterior cerebral arteries; DIAS-4 was terminated prematurely after the results of DIAS-3 revealed lack of efficacy. In DIAS-4, despite a statistically significant 23% absolute difference in recanalization, only an insignificant 6% difference in the proportion of patients with modified Rankin Scale score of 0 to 2 was observed. In the pooled analysis, a total of 795 patients with a median time to treatment of ≈7 hours were included. A similar pattern of results emerged: despite a significant absolute …
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