ATS Reading List Podcast — Episode 4 - Submassive Pulmonary Embolism
Highlights
- The Differences Between the Drugs Used in the Pythotrial and the MAPET Trial
Key takeaways:
- When looking at the bleeding risk in the pythotrial study, the risk is proportionately higher than what was studied in the real world.
- The drug studied in the pythotrial was different than the drug studied in the MAPET trial, and tenectiplase is given as a pushdose agent, which may increase the time it takes for the drug to reach its peak effect.
Transcript:
Speaker 1
So I think I think your point is well taken that when you take the look at the bleeding risk in the pythot trial and try to apply that study concepts into the real world, the bleeding that you get is proportionately higher than what we studied. And I think that's why people we got scared with the pythotrial results that these are the patients you expect least to bleed, but they still bled with TPM. One thing on the same notice I think I'd like to unpack is that this is a drug was different. So I think a lot of people kind of want to, I mean, should know that the drug that we studied in the pythotrial was tenectiplase. The drug that was studied in the MAPET through trial was L-Typase. Tenectiplase is given weight base, which is I think a great, great thing, at least even in this trial, but it's given as a push-dose drug. Any thrombolytic, when you give a push-dose agent, time to reach the peak effect is higher. Are these bleeding events related to that? I don't know that. But tenectiplase is slightly different than L-Typase. L-Typase, when we give it, we give it a small bolus followed by infusion over two hours versus tenectiplase, which was the drug of choice in the pythotrial was given as a bolus. Also to our trainees that tenectiplase is not FDA-approved to be used in the PE in the USA. So that's why we didn't participate in the previous trial, the pythotrial. I don't think any of the US sites were involved. So it's a slightly different molecule. We don't. We had the drugs. Altipase and tenectiplase has been studied hit to hit in the stroke world in the MI world, but never had been studied hit to hit world. (Time 0:36:56)