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April 2009

Tissue Plasminogen Activator Does Not Benefit Most Eligible Patients With Stroke—Reply

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Neurol. 2009;66(4):538-542. doi:10.1001/archneurol.2009.44

In reply

As Lansberg and Schwartz correctly point out, in the first of our analyses, based on Saver's article we included patients who recovered spontaneously and added the partial and complete recoveries to them, showing that more than half of the patients recovered to some extent when given the drug. However, we then provided an illustration based on the pooled data from all of the acute tPA stroke treatment trials available in the literature before our article was written (included in Figure 2 in the original article), which showed an improvement better than 50% and is not dependent on the article by Saver. Finally, our own independent analysis in the last example in the article (shown in the Table in the original article) using the Wilcoxon test indicated that 57.3% of the treated patients improved to some extent. Therefore, through these 3 independent means, we demonstrated that the treated patients were more likely than not to recover to some extent.

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