ISIS-3 final results

Executive Summary

Lancet editorial summarizes results of the comparative study of thrombolysis therapy with Burroughs Wellcome's TPA (duteplase), SmithKline Beecham's APSAC product Eminase or streptokinase by stating that "the clearest message to emerge from this massive enterprise is that both null hypotheses survived intact -- i.e., no thrombolytic regimen performed better, in terms of 35-day survival, than the simple and cheap ISIS-2 cocktail [streptokinase and aspirin]." The final study data are essentially the same as preliminary results from a year ago showing that mortality rates 35 days after myocardial infarction were 10.3% for the TPA group versus 10.6% in the Eminase group and 10.5% for patients receiving streptokinase. The editorial notes that the question of whether TPA was at a disadvantage because concomitant I.V. heparin was not administered should be answered by results of the ongoing 41,000-patient trial GUSTO (Global Utilization of Streptokinase and TPA in Occluded Coronary Arteries). According to Genentech, maker of the TPA product Activase, GUSTO has enrolled 15,000 patients with 500 new patients per week.