Why the study?
Systemic thrombolysis improves outcomes in pulmonary embolism but carries a risk of hemorrhage, and data regarding the efficacy and safety of reduced-dose alteplase are limited.
Does reduced-dose alteplase reduce hemorrhagic complications while maintaining efficacy compared to full-dose alteplase in hospitalized patients with acute pulmonary embolism?
Does reduced-dose alteplase reduce hemorrhagic complications while maintaining efficacy compared to full-dose alteplase in hospitalized patients with acute pulmonary embolism?
Reduced-dose alteplase for acute pulmonary embolism provides similar hemodynamic improvements to full-dose therapy and may reduce hemorrhagic complications, though statistical significance was lost after propensity score adjustment.
May support reduced-dose alteplase to limit bleeding in PE; leaves open need for RCTs before practice change.
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Melamed et al. (2024) studied this question.
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