Comparative safety and efficacy of 0.6 mg/kg versus 0.9 mg/kg alteplase in acute ischemic stroke: a systematic review and meta-analysis.

ABSTRACT:

Background

Alteplase is the standard thrombolytic therapy for acute ischemic stroke, with 0.9 mg/kg as the widely recommended dose. However, a lower dose of 0.6 mg/kg has been used, particularly in some populations, to reduce bleeding risk. We conducted a meta-analysis to compare the efficacy and safety of 0.6 mg/kg versus 0.9 mg/kg alteplase.

Methods

A systematic search identified 11 observational studies and randomized controlled trials totaling 6,148 patients who received either low-dose or standard-dose alteplase within 4.5 h of symptom onset. Outcomes evaluated included symptomatic intracranial hemorrhage (sICH), any intracranial hemorrhage (ICH), 90-day mortality, in-hospital mortality, and functional outcomes measured by the modified Rankin Scale (mRS). Random-effects

SUBMITTER: Ewais AS 

PROVIDER: S-EPMC12625435 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature