Does IV DNase I improve complete recanalization following EVT in AIS patients treated with IVT?
In a pilot study of AIS patients undergoing EVT, IV DNase I was safe but did not significantly improve complete recanalization rates.
Abstract Background and aims Preclinical studies have suggested that deoxyribonuclease I (DNase I) may enhance the efficacy of intravenous thrombolysis (IVT). In this clinical pilot study, we evaluated the safety and efficacy of IV DNase I in AIS patients treated with IVT who were eligible for EVT. Methods In this phase II, single-centre, prospective, open-label, non-randomized study, we enrolled patients with AIS presenting with ICA, M1 or M2 occlusion treated with IVT. Patients received a fixed dose of 35 mg of IV DNase I (dornase alfa) administered at the start of the EVT procedure. The primary outcome was complete recanalization following EVT. Secondary outcomes included recanalization prior to EVT, early neurological improvement, ICH rate at 24 hours, thromboinflammatory parameters in blood withdrawn at 3 time-points and in EVT-retrieved thrombi, and the mRS score at 3 months. A control group was retrospectively selected using 1:1 propensity score matching from a concurrently conducted prospective biobanking study with similar blood sampling. Results A total of 34 AIS patients were included and received IV dornase alfa. The primary outcome occurred at a similar proportion compared to the predefined reference complete recanalization rate set at 60% (p=0.983). Symptomatic ICH occurred in 3/34 patients (8.8%). Extensive clinical, radiological, and biological analyses are ongoing, comparing the DNAse I-treated group with the matched control group and will be presented during the ESO conference. Conclusions In this pilot study, we demonstrate that IV DNase I in AIS patients treated with IVT and undergoing EVT was safe but without significant increase in complete recanalization following EVT. Conflict of interest
Desilles et al. (Fri,) studied this question.