[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
April 26, 2000

Intra-arterial Prourokinase for Acute Ischemic Stroke

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(16):2102-2104. doi:10.1001/jama.283.16.2101

To the Editor: The Prolyse in Acute Cerebral Thromboembolism II (PROACT II) investigators1 reported a benefit of intra-arterial prourokinase compared with placebo for treating patients with acute occlusions of the middle cerebral artery. I am concerned about the appropriateness of the placebo control group for this study. Clinical trial design must compare any proposed therapies with the best available medical treatment. For patients presenting within 3 hours of ischemic stroke onset, the Food and Drug Administration (FDA) has approved intravenous (IV) tissue-type plasminogen activator (tPA). However, because of the study design, some subjects in the placebo group may have been denied this treatment.