Evidence for thrombolytics in stroke – part 4 and a half…

7 Jul

Only  a quickie this time.

I mentioned in the first part that I wasn’t planning to discuss the details of the MAST trials as they used streptokinase as the agent and this is no longer used.

In short both trials were stopped early due to increases in mortality

I re-read them and found this crackingquote from the authors of the second MAST trial. Note that at this stage MAST-I, MAST-E, ECASS I, and ASK trials had all been published and had increased mortality. Only NINDS had been published as +ve. This was 1996.

The possibility cannot be ruled out that the results of the NINDS trial are due to chance; the results of a single trial do not provide sufficient evidence of the efficacy and safety of a drug, especially when similar trials have conflicting results.

I can’t give you a run-down of the aussie ASK trial cause I can’t get access to mid-90s copies of JAMA through my library proxy. Maybe everyone was distracted by Dolly the sheep, or the dawn of the interweb. I wasn’t so much thinking about RCTs in the mid-90s as I was by getting my driving test. That now seems a long time ago… [cue weeping into beer…]


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