Polypharmacy, functional outcome and treatment effect of intravenous alteplase for acute ischaemic stroke

Background and purpose Polypharmacy is an important challenge in clinical practice. Our aim was to determine the effect of polypharmacy on functional outcome and treatment effect of alteplase in acute ischaemic stroke. Methods This was a post hoc analysis of the randomized, placebo‐controlled WAKE‐U...

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Bibliographic Details
Published in:European journal of neurology 2021-02, Vol.28 (2), p.532-539
Main Authors: Jensen, M., Boutitie, F., Cheng, B., Cho, T.‐H., Ebinger, M., Endres, M., Fiebach, J. B., Fiehler, J., Ford, I., Galinovic, I., Königsberg, A., Puig, J., Roy, P., Wouters, A., Thijs, V., Lemmens, R., Muir, K. W., Nighoghossian, N., Pedraza, S., Simonsen, C. Z., Gerloff, C., Thomalla, G.
Format: Article
Language:English
Subjects:
alteplase
Comorbidity
Confidence intervals
Heterogeneity
Intravenous administration
intravenous thrombolysis
ischaemic stroke
Life Sciences
Magnetic resonance imaging
Patients
Placebos
Polypharmacy
Regression analysis
Statistical analysis
Stroke
Thrombolysis
WAKE‐UP
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Summary:Background and purpose Polypharmacy is an important challenge in clinical practice. Our aim was to determine the effect of polypharmacy on functional outcome and treatment effect of alteplase in acute ischaemic stroke. Methods This was a post hoc analysis of the randomized, placebo‐controlled WAKE‐UP trial of magnetic resonance imaging guided intravenous alteplase in unknown onset stroke. Polypharmacy was defined as an intake of five or more medications at baseline. Comorbidities were assessed by the Charlson Comorbidity Index (CCI). The primary efficacy variable was favourable outcome defined by a score of 0–1 on the modified Rankin Scale at 90 days. Logistic regression analysis was used to test for an association of polypharmacy with functional outcome, and for interaction of polypharmacy and the effect of thrombolysis. Results Polypharmacy was present in 133/503 (26%) patients. Patients with polypharmacy were older (mean age 70 vs. 64 years; p 
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.14566