Reteplase: new preparation. Minimal value: bolus versus infusion

The clinical file on reteplase is methodologically sound. A trial versus alteplase involving more than 15 000 patients seen less than 6 hours after myocardial infarction showed that mortality at 30 days was identical in the reteplase and alteplase treatment groups (7.3%). The two treatment groups did not differ either in the frequency of strokes or severe bleeding. Another trial involving more than 6 000 patients seen less than 12 hours after myocardial infarction showed that overall mortality 35 days after thrombolysis was 9% in both the reteplase and the streptokinase treatment groups. The two thrombolytics did not differ in terms of overall mortality at 6 months, the number of strokes, the number of bleeding events or the safety profile. Reteplase is easy to administer (2 intravenous boluses of 10 U, 30 minutes apart). Other reference thrombolytics (streptokinase and alteplase) are administered as an intravenous infusion.