Abciximab plus low-dose thrombolytic could be option for acute MI


NEW YORK (Reuters Health) – Two studies indicate that a combination of abciximab (ReoPro) and a half-dose thrombolytic may be an alternative treatment for acute myocardial infarction (AMI).

Eli Lilly & Co. Inc. said on Friday that researchers would present the findings at the European Society of Cardiology's XXIII Congress in Stockholm.

The ASSENT-3 (ASsessment of the Safety and Efficacy of a New Thrombolytic regimen) study demonstrated that a combination of ReoPro with a half-dose of Genentech's TNKase (tenecteplase) and unfractionated heparin (UFH) reduced ischemic complications by 28% in AMI patients, according to Lilly.

The combination therapy also was superior to tenecteplase and UFH in reducing a composite endpoint of mortality, in-hospital reinfarction or in-hospital refractory ischemia. Only 11.1% of the patients in the abciximab arm experienced such events compared with 15.4% in the UFH arm.

The abciximab group likewise required fewer urgent percutaneous coronary interventions; only 9.1% subsequently required angioplasty following treatment compared to 14.4% of the UFH group.

The ASSENT-3 results are consistent with the findings of the GUSTO study, also to be presented at the European meeting.

GUSTO V demonstrated that a combination of ReoPro with a half-dose of a different thrombolytic, Roche's Rapilysin (reteplase) was comparable in efficacy to monotherapy but without an increase in intracranial hemorrhage, according to Lilly.

The GUSTO V study also indicated that combination therapy reduced recurrent MI rates. In the monotherapy arm, 3.5% of the patients experienced a second MI compared with 2.3% in the combination therapy arm.

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