Lanoteplase is a recombinant
plasminogen activator, which when administered as a single bolus
intravenous injection, displays thrombolytic activity. In the phase II InTIME trial,
lanoteplase dose-dependently increased reperfusion rates at 60 and 90 minutes in patients with acute
myocardial infarction and at 90 (but not 60) minutes
lanoteplase 120 kU/kg was significantly superior to
alteplase in restoring TIMI grade 2 and 3 flow (in 83.0 and 71.4% of patients, respectively). Preliminary results from the phase III InTIME-II study showed that
lanoteplase was as effective as
alteplase in decreasing 30-day mortality. At 30 days, the combined incidence of death, reinfarction, major
bleeding and
heart failure was lower with
lanoteplase 120 kU/kg than with
alteplase 100mg. From preliminary results of the large InTIME-II study,
lanoteplase 120 kU/kg showed a greater incidence of intracranial haemorrhage and mild
bleeding than
alteplase <or=100mg, but a similar incidence of
stroke. The smaller InTIME study showed a tendency for fewer adverse events with
lanoteplase.