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Purpose of Review <p>Stroke is one of the leading causes of long-term morbidity and mortality worldwide. The advent of intravenous thrombolysis in the management of acute ischaemic strokes has been rendered the first line for systemic reperfusion therapy. This paper aims to evaluate the efficacy and safety of prourokinase in the management of AIS, highlighting its prospective safety and concludes by emphasizing the need for further research.</p> <p>A search was conducted across multiple electronic databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Library, to identify relevant studies published from inception to 2025 that assessed the trends, efficacy, safety, and comparative effectiveness of prourokinase in the management of AIS.</p> Recent Findings <p>AIS is a condition with high prevalence and comorbidity. Pooled analyses of phase II randomized trials (PROACT) with inclusion criteria for the study of primarily MCA occlusion confirmed by angiography, absence of hemorrhage or major infarction on computed tomography (CT) scan, and presentation within 3–6&#xa0;h showed 40% of r-ProUK subjects and 25% of controls had a modified Rankin score of 2 or less (<i>P</i> = 0.4). Although there were reported improvements in recanalization rates in acute ischemic strokes, the increased frequency of symptomatic early intracranial hemorrhage reported from the studies limits potential use.</p> Summary <p>Recombinant human prourokinase (rhPro-UK), a fibrin-specific plasminogen activator, has shown promising results from clinical trials. The full therapeutic potential in the global management of acute ischemic stroke will be realized with further research, regulatory evaluation, and integration into clinical guidelines.</p>

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Prourokinase in Acute Ischemic Stroke: A Review of Current Evidence

  • 期刊论文

  • 发表日期：

    2025年8月22日

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  • Oluwaseun Abiola Matthew,
  • Chidera Stanley Anthony,
  • Victor Oluwatomiwa Ajekiigbe,
  • Ikponmwosa Jude Ogieuhi,
  • Ajao Favour Ayomikun,
  • Adetona Fayankinnu,
  • Funmi Aminu,
  • Jagunmolu Habiblah Ayomide,
  • Emmanuel Oyedeji Oyetola,
  • Chidera Ethel Uzuegbunam,
  • Folafunmi Aminat Olajide,
  • Halimat Oluwatosin Sadiq,
  • Obianuju Iheomamere Muoghallu

摘要

Purpose of Review

Stroke is one of the leading causes of long-term morbidity and mortality worldwide. The advent of intravenous thrombolysis in the management of acute ischaemic strokes has been rendered the first line for systemic reperfusion therapy. This paper aims to evaluate the efficacy and safety of prourokinase in the management of AIS, highlighting its prospective safety and concludes by emphasizing the need for further research.

A search was conducted across multiple electronic databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Library, to identify relevant studies published from inception to 2025 that assessed the trends, efficacy, safety, and comparative effectiveness of prourokinase in the management of AIS.

Recent Findings

AIS is a condition with high prevalence and comorbidity. Pooled analyses of phase II randomized trials (PROACT) with inclusion criteria for the study of primarily MCA occlusion confirmed by angiography, absence of hemorrhage or major infarction on computed tomography (CT) scan, and presentation within 3–6 h showed 40% of r-ProUK subjects and 25% of controls had a modified Rankin score of 2 or less (P = 0.4). Although there were reported improvements in recanalization rates in acute ischemic strokes, the increased frequency of symptomatic early intracranial hemorrhage reported from the studies limits potential use.

Summary

Recombinant human prourokinase (rhPro-UK), a fibrin-specific plasminogen activator, has shown promising results from clinical trials. The full therapeutic potential in the global management of acute ischemic stroke will be realized with further research, regulatory evaluation, and integration into clinical guidelines.