Evidence map›Paper›PMID 40170345›Full record

SynthesisClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

Efficacy and Safety of Recombinant Human Prourokinase in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Abdulaziz A Alzahrani, Ahmed A Maiz, Ahmed A Ibrahim, Mohamed Rifai, Suhaiyh Sanad Alotibi, Leena Salem, Hadeel A Alzabidi, Sarah Mansour Alshehri, Yara Fahad Almazyad, Zeyad T Mansour and 1 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Abdulaziz A AlzahraniFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Ahmed A MaizFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Ahmed A IbrahimFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Mohamed RifaiFaculty of Medicine, Menoufia University, Menoufia, Egypt.ORCID 0009-0007-9457-9832
Suhaiyh Sanad AlotibiFaculty of Medicine, Taif University, Taif, Saudi Arabia.ORCID 0009-0000-1761-0612
Leena SalemFaculty of Medicine, Alrayan Colleges, Madinah, Saudi Arabia.
Hadeel A AlzabidiFaculty of Medicine, Umm Alqura University, Makkah, Saudi Arabia.
Sarah Mansour AlshehriFaculty of Clinical Pharmacy, King Khalid University, Abha, Saudi Arabia.
Yara Fahad AlmazyadCollege of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia.
Zeyad T MansourFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Abubaker Osman AhmedEmergency Department, Hayat National Hospital, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute ischemic stroke (AIS) is a leading cause of mortality and disability worldwide. Recombinant human prourokinase (rhPro-UK) has emerged as a promising thrombolytic agent amid the global shortage of thrombolytics. We assessed the safety and efficacy of rhPro-UK in AIS patients within 4.5 h of stroke onset through a systematic review and meta-analysis of RCTs from PubMed, Web of Science, Scopus, and Cochrane until January 2024. Data were pooled using risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI) in R version 4.3. PROSPERO ID: CRD42025638980. Three RCTs (2289 patients) were included. rhPro-UK showed comparable efficacy to recombinant tissue plasminogen activator (r-tPA) in excellent neurological recovery (mRS 0-1: RR 1.04, 95% CI [0.98, 1.10], P = 0.19) and functional independence (mRS 0-2: RR 1.00, 95% CI [0.96, 1.05], P = 0.87). However, rhPro-UK significantly reduced NIHSS scores at 24 h (MD -0.43, 95% CI [-0.85, -0.02], P = 0.04) and seven days (MD -0.85, 95% CI [-1.39, -0.30], P < 0.01), and decreased systemic bleeding (RR 0.60, 95% CI [0.49, 0.75], P < 0.01). No significant differences were observed in 90-day mortality (RR 1.13, 95% CI [0.62, 2.05], P = 0.69) or intracerebral hemorrhage (RR 0.83, 95% CI [0.61, 1.13], P = 0.23). rhPro-UK demonstrates comparable efficacy to r-tPA with reduced NIHSS scores and systemic bleeding, supporting its role as a cost-effective and safer alternative for AIS treatment within 4.5 h. Further investigation in stroke management protocols is warranted.

Indexed as

Fibrinolytic AgentsIschemic StrokePlasminogen ActivatorsHumansRecombinant ProteinsTreatment OutcomeFibrinolytic AgentsPlasminogen ActivatorsRecombinant Proteinsalteplaseemergencystrokethrombolyticsurokinase

Identifiers

PMID40170345
PMCPMC11963787

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.