Urokinase Therapy: Dose Reduction by Administration in Plastic Material

Zimmermann, Rainer; Schöffel, Gerhard; Harenberg, Job

doi:10.1055/s-0038-1650193

Cited by 4 publications

(2 citation statements)

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“…The in fusion of about 4 X 106 U/12h [5], 1.7 X 106 U/12 h [8], 0.5 X 106 U/day [7] have been reported to produce a decrease of about 50% of a2-antiplasmin. Interindividual dif ferences in the level of blood UK inhibitors, different dosage schedules, differences in the activity of various UK preparations, and dif ferences in the storage procedure of UK dur ing infusion [19] have to be considered in order to explain this large variation in dos age.…”

Section: Discussionmentioning

confidence: 99%

Laboratory Control of Urokinase Therapy at Low or Moderate Dosages

Musumeci

Zappacosta

Caruso

et al. 1983

Pathophysiol Haemos Thromb

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In vitro thrombolytic experiments were performed in a system composed of a radioactive clot (¹²⁵I fibrinogen) perfused by whole anticoagulated blood to which a small amount of urokinase (UK) was added by continuous infusion. At various intervals a small aliquot of blood was drawn from the system and assayed for fibrinogen, plasminogen and α₂-antiplasmin. Results were correlated with the degree of thrombolysis measured continuously as decrease of clot radioactivity by a ratemeter connected to a recorder. The coefficients of correlation between fibrinogen, plasminogen and thrombolysis were -0.45 and -0.46, respectively (p < 0.001). The highest coefficient of correlation was observed between α₂-antiplasmin change and thrombolysis (-0.84; p < 0.001). Results indicate that the initiation of an effective thrombolytic state induced by UK required the depletion of about 50% of α₂-antiplasmin. The measurement of α₂-antiplasmin during UK therapy at low or moderate dosage appears to be useful for dosage adjustments leading to the development of a thrombolytic state.

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Section: Discussionmentioning

confidence: 99%

Laboratory Control of Urokinase Therapy at Low or Moderate Dosages

Musumeci

Zappacosta

Caruso

et al. 1983

Pathophysiol Haemos Thromb

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“…Unter h6herer Dosierung erfolgt offensichtlich eine raschere Aktivierung des fibrinolytischen Systems, die gerinnungsanalytisch in einer ausgepr/igten fibrinogenolytischen Wirkung zum Ausdruck kommt [22]. Dartiberhinaus sollten allerdings auch Unterschiede der Pr~iparation und des Molekulargewichtes der eingesetzten Urokinase und die Verabreichungsweise als bedeutsame Faktoren bei der Erfolgsbeurteilung von Urokinasedosierungsschemata diskutiert werden [39]. Dartiberhinaus sollten allerdings auch Unterschiede der Pr~iparation und des Molekulargewichtes der eingesetzten Urokinase und die Verabreichungsweise als bedeutsame Faktoren bei der Erfolgsbeurteilung von Urokinasedosierungsschemata diskutiert werden [39].…”

Section: Ger#mungsanalytische Befundeunclassified

Thrombolytische Therapie der tiefen Beinvenenthrombose mit Urokinase

et al. 1982

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In 81 patients with deep vein thrombosis of the lower limb, urokinase therapy was performed in combination with heparin according to a new regimen at higher dosages. When urokinase was administered at an initial maintenance dosage of 1,000-2,000 IU/kg/h (loading dose 150,000-250,000 IU), phlebographically documented complete or partial recanalization could be observed in 68% of the cases. The higher dosage schedule induced a more pronounced deobliteration especially in treatment of iliac vein thromboses (67% recanalization) in comparison to the lower dosage regimen (only 43% recanalization). Nearly comparable therapeutic results could be achieved in therapy of popliteal or saphenous vein thromboses. The data suggest that the higher dosage schedule examined here is indicated in treatment of extensive and large volume thromboses. The dosage of urokinase was further adjusted to attain a reduction of fibrinogen to 50-100 mg/dl. The concentration should not fall below 50 mg/dl. Therapy with urokinase proved practicable. Serious side effects did not occur. 8.6% of the patients showed hematuria and 6% a decrease of the Hb by more than 2 g/dl. The high proportion of older thromboses and the only low rate of recanalization (23%) in these cases suggest the necessity of an early commencement of fibrinolyses in therapy of deep vein thrombosis.

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