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March 11, 1974

The Urokinase-Pulmonary Embolism Trial

Author Affiliations

Marshfield Clinic Marshfield, Wis

JAMA. 1974;227(10):1168-1169. doi:10.1001/jama.1974.03230230044026

A preliminary report regarding the results of the Urokinase-Pulmonary Embolism Trial appeared in JAMA1 in 1970. The entire concept, specific aims, and results of this trial were published in Circulation2 in 1973. Still, there remains a misconception regarding the purpose of this trial and there have been gross misinterpretations of the results.3

This study was not a therapeutic trial, and mortality was not used as an endpoint. The trial was not designed to determine whether or not urokinase therapy was more beneficial than heparin sodium therapy in the treatment of patients with pulmonary embolism, and no therapeutic recommendations have been made. The express purpose of the trial was to determine whether or not urokinase would accelerate the lysis of pulmonary emboli over and above the natural lytic process. Page II-15 from the article in Circulation2 contains the following paragraph.

The primary objective of this controlled Trial