title: Acute stroke therapy with tissue plasminogen activator (tPA) since it was approved by the U.S. Food and Drug Administration (FDA).
abstract: Tissue plasminogen activator (tPA) for acute ischemic stroke was approved by the U.S. Food and Drug Administration (FDA) in 1996. Since then it has been severely underutilized. At the time when most practitioners were first being exposed to the literature concerning tPA, there were many concerns about safety and the restrictions on use were quite onerous. Since then a good deal of further work has been done to loosen the restrictions and allay concerns about the risks. The true risk to benefit ratio is far better than is generally realized. Now it is mostly economic problems related to the costs of constantly supplying emergency care that is limiting access. Furthermore, in the current litigious environment, failure to treat is likely to be a more hazardous course of action than legal exposure due to poor outcomes. It must be emphasized that the drug is quite safe and highly effective, and current utilization rates are unacceptably low. Ann Neurol 2009;66:6-10.
authors.affiliation: Department of Neurosciences, University of California, San Diego (UCSD) School of Medicine, La Jolla, CA, USA. jzivin@UCSD.edu
authors.forename: Justin A
authors.initials: JA
authors.lastname: Zivin
mesh_terms: D017277:Drug Approval / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000191:economics / Q000627:therapeutic use*; D014481:United States; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence* / Q000592:standards
chemical_list: D010959:Tissue Plasminogen Activator