A Three-arm Randomized Controlled Non-inferiority Pilot Study Comparing Anticoagulation Strategies Using Unfractionated Heparin, Argatroban and Low-molecular-weight Heparin for Extracorporeal Membrane Oxygenation Support

A three-arm randomized controlled non-inferiority pilot study comparing anticoagulation strategies using unfractionated heparin, argatroban and enoxaparin for extracorporeal membrane oxygenation support conducted as an investigator-initiated, prospective, parallel group, open-label, active comparator controlled, single center, phase IV study to evaluate the non-inferiority of enoxaparin or argatroban for anticoagulation during ECMO therapy in comparison to the current standard, unfractionated heparin, as measured by the incidence of thromboembolic events during the duration of ECMO therapy

Start Date30 Jul 2024

Sponsor / Collaborator

Medical University of Vienna

EUCTR2022-002259-20-AT / Unknown statusPhase 4IIT

A three-arm randomized controlled non-inferiority pilot study Comparing Anticoagulation Strategies using Unfractionated heparin, Argatroban and Low-molecular-weight heparin for Extracorporeal Membrane Oxygenation support - CASUAL ECMO Trial

Start Date17 Aug 2023

Sponsor / Collaborator

Medical University of Vienna

NCT05226442 / CompletedPhase 2/3IIT

A Prospective Randomized Pilot Trial on Safety and Feasibility of Argatroban As Anticoagulant in Patients with Extracorporeal Membrane Oxygenation (ECMO)

This prospective, randomized, controlled pilot trial aims to assess the safety and feasibility of Argatroban as an alternative anticoagulant to unfractionated heparin in patients receiving extracorporeal membrane oxygenation.

Start Date01 Dec 2021

Sponsor / Collaborator

Medical University of Vienna

100 Clinical Results associated with Argatroban

100 Translational Medicine associated with Argatroban

100 Patents (Medical) associated with Argatroban

1,591

Literatures (Medical) associated with Argatroban

01 Jan 2025·Journal of Stroke & Cerebrovascular Diseases

Safety and efficacy of argatroban combined with antiplatelet therapy for acute mild-to-moderate ischemic stroke with large artery atherosclerosis

Article

Author: Tan, Xin ; Wu, Guanhui ; Yu, Shuai ; Xu, Guoli ; Zhao, Huimin ; Cheng, Qingzhang ; Xu, Qinrong ; Gui, Qian ; Feng, Hongxuan ; Dong, Xiaofeng ; Yan, Jia

BACKGROUND AND PURPOSE:

Patients with stroke due to large artery atherosclerosis are at risk of early progression and recurrence. The efficacy and safety of argatroban in stroke patients who did not receive reperfusion therapy, and which patients may benefit from it, are uncertain.

METHODS:

We conducted a cohort study to assess whether argatroban given within 72 hours of symptom onset, combined with antiplatelet therapy, improved neurological outcomes of patients with acute mild to moderate ischemic stroke in China. Patients were divided into the combined treatment group and the control group. Inverse probability of treatment weighting was used to balance baseline covariates. The primary efficacy outcome is the proportion of mRS score 0-2 at 90 days. The secondary efficacy outcomes included END proportion, change in NIHSS score from the baseline to day 7, recurrent cardiovascular events, and cardiovascular death. The safety outcomes were hemorrhagic transformation (HT) of infarction and organ hemorrhage at 7 days.

RESULTS:

Compared with the control group, a higher proportion of mRS (0-2) at 90 days was found in patients in the combined treatment group (85.3% vs 74.5%, p=0.042). There was no significant difference in the safety outcomes between the two groups. Exploratory subgroup analysis showed positive associations with argatroban combined therapy and good prognosis in NIHSS score ≥5 and age ≥70 subgroups.

CONCLUSIONS:

Our study suggested that argatroban can improve neurological outcomes for mild to moderate LAA patients but not increase the risk of bleeding.

26 Nov 2024·Blood Advances

Antithrombotic efficacy and bleeding risks of vaccine-induced immune thrombotic thrombocytopenia treatments

Article

Author: Ahmadi, Zohra ; Leung, Halina H. L. ; Lee, Brendan ; Perdomo, Jose ; Ratnasingam, Sumita ; Casey, John ; Chong, Beng H. ; McKenzie, Steven E.

Abstract:

Current guidelines for treating vaccine-induced immune thrombotic thrombocytopenia (VITT) recommend nonheparin anticoagulants and IV immunoglobulin (IVIg). However, the efficacy of these treatments remains uncertain due to case studies involving small patient numbers, confounding factors (eg, concurrent treatments), and a lack of animal studies. A recent study proposed danaparoid and heparin as potential VITT therapies because of their ability to disrupt VITT IgG-platelet factor 4 (PF4) binding. Here, we examined the effects of various anticoagulants (including unfractionated [UF] heparin, danaparoid, bivalirudin, fondaparinux, and argatroban), IVIg, and the FcγRIIa receptor-blocking antibody, IV.3. Our investigation focused on VITT IgG-PF4 binding, platelet activation, thrombocytopenia, and thrombosis. Danaparoid, at therapeutic doses, was the sole anticoagulant that reduced VITT IgG-PF4 binding, verified by affinity-purified anti-PF4 VITT IgG. Although danaparoid and high-dose UF heparin (10 U/mL) inhibited platelet activation, none of the anticoagulants significantly affected thrombocytopenia in our VITT animal model and all prolonged bleeding time. IVIg and all anticoagulants except UF heparin protected the VITT mice from thrombosis. Direct FcγRIIa receptor inhibition with IV.3 antibody is an effective approach for managing both thrombosis and thrombocytopenia in the VITT mouse model. Our results underscore the necessity of animal model investigations to inform and better guide clinicians on treatment choices. This study provides compelling evidence for the development of FcγRIIa receptor blockers to prevent thrombosis in VITT and other FcγRIIa-related inflammatory disorders.

25 Nov 2024·Hematology-American Society of Hematology Education Program

Troubleshooting heparin resistance

Article

Author: Maier, Cheryl L. ; Levy, Jerrold H. ; Connors, Jean M.

Abstract:

The term heparin resistance is likely best defined as the failure of an appropriate dose of unfractionated heparin (UFH) to achieve a predetermined level of anticoagulation. Unfortunately, and despite many prior reports, there is no established consensus as to what either the appropriate dose or the predetermined level should be. Traditionally, assays used to monitor anticoagulation with UFH have been clot based, including the activated partial thromboplastin time, used for patients on the ward or intensive care unit, and the activated clotting time, used for patients undergoing vascular interventions and cardiopulmonary bypass. Unfortunately, these tests may be highly influenced by other factors occurring in many patients, especially those with inflammation or acute infection, as noted during the COVID-19 pandemic. Many hospitals have thus moved to anti-Xa testing for heparin monitoring. Another important factor in defining heparin resistance includes dosing, whether weight-based or total daily dosing is used, as initial reports of heparin resistance described daily doses independent of body weight. Multiple causes of apparent heparin resistance include hypercoagulability, antithrombin deficiency, andexanet alfa used for direct oral anticoagulant reversal, thrombocytosis, and antiphospholipid antibody syndromes. Treatment options for managing patients with heparin resistance include weight-based dosing and administration of additional UFH, antithrombin supplementation, or the use of an alternative anticoagulant such as the direct thrombin inhibitors bivalirudin or argatroban.

News (Medical) associated with Argatroban

06 Sep 2024

·www.drugs.com

Adjunctive IV Argatroban, Eptifibatide Do Not Cut Disability After Stroke

FRIDAY, Sept. 6, 2024 -- Adjunctive treatment with intravenous argatroban or eptifibatide does not reduce poststroke disability among patients with acute ischemic stroke treated with intravenous thrombolysis within three hours after symptom onset, according to a study published in the Sept. 5 issue of the New England Journal of Medicine . Opeolu Adeoye, M.D., from Washington University in St. Louis, and colleagues conducted a phase 3, randomized, controlled clinical trial at 57 U.S. sites involving patients with acute ischemic stroke who had received intravenous thrombolysis within three hours after symptom onset. Participants received intravenous argatroban (59 patients), eptifibatide (227 patients), or placebo (228 patients) within 75 minutes after initiation of thrombolysis. The researchers found that at 90 days, the mean utility-weighted modified Rankin scale scores were 5.2 ± 3.7, 6.3 ± 3.2, and 6.8 ± 3.0 with argatroban, eptifibatide, and placebo, respectively. The posterior probabilities that argatroban was better than placebo and that eptifibatide was better than placebo were 0.002 and 0.041, respectively (posterior mean difference in utility-weighted modified Rankin scale score, −1.51 ± 0.51 and −0.50 ± 0.29, respectively). The three groups had a similar incidence of symptomatic intracranial hemorrhage (4, 3, and 2 percent, respectively). Mortality at 90 days was higher in the argatroban and eptifibatide groups versus the placebo group (24 and 12 percent, respectively, versus 8 percent). "We found no benefit of adjunctive intravenous argatroban or eptifibatide in patients with acute ischemic stroke treated with intravenous thrombolysis within three hours after symptom onset," the authors write. Several authors disclosed ties to the biopharmaceutical industry.

Clinical ResultPhase 3

16 Jul 2024

·www.prnewswire.com

Benzodiazepine Drugs Market to Reach US$ 3.2 Billion by 2034, Growing at 3.5% CAGR | Impact of Psychological Conditions and Aging Population - Reports TMR

Benzodiazepine drugs are vastly used as psychoactive drugs, which can be used to control seizures, alcohol withdrawal symptoms, and other issues related to the psychological conditions of a human being. With the activity of drugs closely related to brain stimulation, the drug can act as a relaxant for muscles in the body. WILMINGTON, Del., July 16, 2024 /PRNewswire/ -- Owing to different governing factors, the development of the benzodiazepine drug market is expected to traverse a sluggish path of advancement during the forecasted period. With a CAGR of 3.5%, the industry will proceed to reach USD 3.2 billion by 2034. The last recorded size of the ecosystem was USD 2.2 billion in 2023. With the changing lifestyles and mounting pressures to cope with an accelerated pace of living, many people have been facing psychological issues. The growing prevalence of trauma, anxiety, mental fatigue, and many other psychological conditions is observed to have increased recently. To treat such medical conditions, an appropriate relaxant must be applied to get the desired results. This growing prevalence is a clear sign of an important driver that promises to elevate the size of the competitive space during the forecasted period. The rising geriatric population is contributing to the growing cases of insomnia. Along with the abovementioned factors, the growing senior population is trying to find solutions for issues like sleep deprivation. To cater to such issues, the use of benzodiazepine drugs is observed to have increased. Propel Your Business Success: Secure Your Sample of Our Latest Report Now! Due to the sedative properties of drugs, the use of such chemicals is observed to have gained traction in the case of muscle relaxants. To cater to such muscle spasms and other related issues, such drugs can be effective. This factor drives the sales of such drugs. With the spurring of innovation and growth in the technological infrastructure, product augmentation has become possible. Key players in the ecosystem invest more in innovation to alter formulations of drugs. This elevates drug delivery and response time, delivering better results. Rising investments in the pharmaceutical and healthcare industries have generated better prospects for leading organizations. As more market openings have been created in the industry, the scope of expanding the market increases for key players, benefitting the size of the industry. The growing research and development activities are expected to augment the drug efficacy and efficiency, which will likely benefit the industry. Due to this, such efforts have been fueling the industry's progress, creating opportunities for new entrants. Benzodiazepine Drugs Market Report Scope: Key Findings from the Market Report The competitive landscape of benzodiazepine drugs can be segmented into different categories depending on various parameters. Based on the drug type, Alprazolam is used to control anxiety issues. The drug controls an abnormal excitement in the brain. Based on the application segment, anxiety is the largest shareholder in the industry. Due to the changing lifestyle, such cases are increasing at an alarming rate, gaining more demand for the segment. Based on the time of use, various prolonged cases of such drugs are seen to have gained momentum. Curing deep psychological impacts is surging the demand for the segment. Based on the end-user, hospital pharmacies govern the largest market share due to better availability of drugs. Regional Profile The growing awareness of psychological health in Asia-Pacific is creating better prospects for the global benzodiazepine drug market. With the growing drug research activities in Europe, the demand for such drugs will likely increase due to a larger canvas. The progress of the healthcare and pharmaceutical industry in North America is a key factor in helping the region lead the global landscape. Competitive Landscape Among different firms expanding in the industry, Pfizer Inc. is a key player that produces different products to expand. Such products include aminophylline, etomidate, argatroban injection, and many more. UCB S.A. is another important player producing solutions for Briviact (brivaracetam) Epilepsy, Ankylosing spondylitis, and Myasthenia Gravis. Hikma Pharmaceuticals PLC operates in different verticals, including injectables, oral drugs, and other segments. Key Developments in the Benzodiazepine Drug Market In December 2023, Pfizer Inc. acquired Seagen. This move bolstered the position of the organization in the industry. In March 2024, UCB S.A. invested in IMIDomics, Inc. to innovate solutions for immune-mediated inflammatory diseases. This product launch helped the business augment products, bolstering the position in the market. Key Players Pfizer Inc. UCB S.A. Hikma Pharmaceuticals PLC Teva Pharmaceutical Industries Ltd. H.Lundbeck A/S Apotex Inc. Aurobindo Pharma Purdue Pharma Other Prominent Players Market Segmentation Drug Type Alprazolam Clonazepam Diazepam Lorazepam Others (Midazolam, etc.) Application Anxiety Insomnia Alcohol Withdrawal Seizures Others (Bipolar Disorder, etc.) Time of Action Ultra-short Acting Short Acting Long Acting End User Hospital Pharmacies Retail Pharmacies Online Pharmacies Region North America Europe Asia Pacific Latin America Middle East & Africa Drive Your Business Growth Strategy: Purchase the Report for Key Insights! Have a Look at Related Research Reports of Pharmaceutical Cardiovascular Drugs Market - The global cardiovascular drugs market, valued at USD 142.8 billion in 2022, is projected to grow at a compound annual growth rate (CAGR) of 3.8% from 2023 to 2031. This growth trajectory is expected to elevate the market size to USD 195.6 billion by the end of 2031, driven by increasing prevalence of cardiovascular diseases, advancements in drug development, and rising healthcare expenditures globally. Insomnia Market - The global insomnia industry was worth US$ 3.8 billion in 2022. From 2023 to 2031, it is expected to increase at a CAGR of 6.0%, reaching US$ 6.4 billion. Various therapies have been explored for managing insomnia, offering non-pharmacological alternatives for those seeking sleep improvement. Bioengineered Protein Drugs Market - Rise in incidence of chronic diseases such as infectious diseases, autoimmune disorders, and cancer is a dominating factor contributing to the bioengineered protein drugs market growth. About Transparency Market Research Transparency Market Research, a global market research company registered at Wilmington, Delaware, United States, provides custom research and consulting services. Our exclusive blend of quantitative forecasting and trends analysis provides forward-looking insights for thousands of decision makers. Our experienced team of Analysts, Researchers, and Consultants use proprietary data sources and various tools & techniques to gather and analyses information. Our data repository is continuously updated and revised by a team of research experts, so that it always reflects the latest trends and information. With a broad research and analysis capability, Transparency Market Research employs rigorous primary and secondary research techniques in developing distinctive data sets and research material for business reports. Contact: Transparency Market Research Inc. CORPORATE HEADQUARTER DOWNTOWN, 1000 N. West Street, Suite 1200, Wilmington, Delaware 19801 USA Tel: +1-518-618-1030 USA – Canada Toll Free: 866-552-3453 Website: Email: [email protected] Follow Us: LinkedIn | Twitter | Blog | YouTube Logo: SOURCE Transparency Market Research

Acquisition

17 Jun 2024

·www.prnewswire.com

ACQUISITION OF ARGATROBAN BUSINESS IN EUROPE

SAINT-CLOUD, France, June 17, 2024 /PRNewswire/ -- Ethypharm has entered into an agreement with Mitsubishi Tanabe Pharma Corporation (MTPC) to acquire the selective antithrombin agent, Argatroban monohydrate (Argatra®, Arganova®, Novastan®, Exembol®), in Europe. Ethypharm, known for its expertise in essential drugs for central nervous system diseases (including severe pain and addiction) and hospital injectables, aims to strengthen its established pharmaceutical business in Europe through internal development, licensing and acquisitions. In Europe, MTPC first received approval for Argatroban in Sweden in 2004 and the product is currently available as a treatment for heparin-induced thrombocytopenia (HIT) type II in 13 countries, including Germany, the UK, France, Spain and Italy. Heparin induced thrombocytopenia (HIT) type II is a severe condition that carries the risk of fatal thromboembolic complications. Argatroban is an anticoagulant with a short half-life in the bloodstream that undergoes metabolism in the liver, making it suitable for patients post-surgery and those with kidney disease who may develop HIT type II. Denis Delval, CEO of Ethypharm, said: "We are delighted to strengthen our portfolio of essential drugs and bring Argatroban to patients in Europe. Furthermore, we are proud to take over this product following its originator, the well-recognized Mitsubishi Tanabe Pharma Corporation." About Ethypharm Ethypharm is a leading mid-sized international pharmaceutical company, with strong European roots, that manufactures and provides essential drugs, with a focus on hospital care, central nervous system (severe pain and addiction) and internal medicine. Ethypharm is committed to improving patients' lives and making a positive impact on society and the environment. Ethypharm has 1,700 employees dedicated to its various pharmaceutical activities, of which 1400 are in industrial operations. The six production sites located in France, the UK, Spain, and China have expertise in injectables and complex oral solid forms. With a global presence in 68 countries, the company markets its products directly in Europe and China, and has strategic partnerships in the EMEA, NA, LATAM and APAC markets. Ethypharm works closely with the authorities and healthcare professionals to ensure that its medicines are used appropriately and that patients have access to them. To find out more about Ethypharm, visit About Mitsubishi In Europe, MTPC's subsidiary, Mitsubishi Tanabe Pharma Europe Ltd (hereinafter referred to as "MTPE," located in London, United Kingdom), and MTPE's subsidiary, Mitsubishi Tanabe Pharma GmbH (hereinafter referred to as "MTPD, located in Duesseldorf, Germany), have been actively involved in the marketing and sales of argatroban in United Kingdom and Germany, among other European countries, through their respective networks of partners. Mitsubishi Tanabe Pharma Corporation (Chuo-ku, Osaka; Representative Director: Akihiro Tsujimura; hereinafter, "MTPC"), a member of the Mitsubishi Chemical Group remains committed to delivering pharmaceutical products to patients in Europe through MTPE and MTPD, including the continued supply of Radicava® (edaravone), treatment agent for amyotrophic lateral sclerosis, within its European operations, thereby making a meaningful contribution to those facing diseases in the region. The company's six production sites are located in France, the UK, Spain and China. About Mitsubishi Tanabe Pharma Group Mitsubishi Tanabe Pharma Corporation (MTPC), a member of the Mitsubishi Chemical Group, is committed to delivering pharmaceutical products to patients in Europe through Mitsubishi Tanabe Pharma Europe Ltd (MTPE) and Mitsubishi Tanabe Pharma GmbH (MTPD). This includes the continued supply of Radicava® (edaravone), the treatment agent for amyotrophic lateral sclerosis, thereby making a meaningful contribution to those facing diseases in the region. In Europe, MTPE and its subsidiary MTPD have been actively involved in the marketing and sales of argatroban in the UK and Germany, among other European countries, through their respective networks of partners. Logo - Media contact: Ethypharm: Avril Ponnelle, [email protected]

Drug ApprovalAcquisition

100 Deals associated with Argatroban

External Link

KEGG	Wiki	ATC	Drug Bank
D00181	Argatroban	B01AE03	DB00278

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Heparin-induced thrombocytopenia and thrombosis	JP	Alfresa Pharma Corp.	16 Jul 2008
Thrombosis	JP	Mitsubishi Tanabe Pharma Corp.	01 Jul 2005
Heparin-induced thrombocytopenia	SE	Mitsubishi Tanabe Pharma GmbH	01 Mar 2005
Arteriosclerosis Obliterans	CN	Mitsubishi Pharma Corp.	02 Aug 2002
Ischaemic cerebral infarction	CN	Mitsubishi Pharma Corp.	02 Aug 2002
Thromboangiitis Obliterans	CN	Mitsubishi Pharma Corp.	02 Aug 2002
Thrombocytopenia	US	Sandoz, Inc.	30 Jun 2000
Antithrombin III Deficiency	JP	Alfresa Pharma Corp.	16 Apr 1996
Thrombosis of cerebral veins	JP	Alfresa Pharma Corp.	16 Apr 1996

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Angina, Unstable	Phase 2	BE	Mitsubishi Tanabe Pharma Corp.	01 Aug 2005
Angina, Unstable	Phase 2	DE	Mitsubishi Tanabe Pharma Corp.	01 Aug 2005

Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05740371 (SAICoDis, CTgov)	Phase 4	Angina, Unstable	50	Argatroban (Argatroban Intravenous (i.v.) Bolus & i.v. Infusion (ITT Population))	wiqkslmuye(jssemptoyy) = vzwojmjcmu hcmmhqavdg (bjibxqjnlo, obwefyqtsg - qhjpnnrhfk)	-	18 Mar 2024
				Argatroban (Argatroban Intravenous (i.v.) Bolus & i.v. Infusion (ITT Population/Sub Group Male))	zgimftazmd(ywixztdjyy) = oontzglvxd raqxkdepuw (evvvymbqfq, ttumzajflg - yncxnfwuer)
NCT04406389 (IMPACT, CTgov)	Phase 4	COVID-19	14	Unfractionated heparin+Fondapariniux+Enoxaparin sodium (Intermediate Dose Prophylaxis)	fvcwxohbhn(xlrizeweyy) = xwuvkaujxz coyfxxysyi (hnfktdxlog, sbkqzvxhnr - ktzxxnodsj) View more	-	21 Sep 2023
				Unfractionated heparin+Fondapariniux+Argatroban+Enoxaparin sodium (Therapeutic Dose Anticoagulation)	fvcwxohbhn(xlrizeweyy) = qkqotavfqz coyfxxysyi (hnfktdxlog, cgkbhsxgsd - elplwtflib) View more
NCT03740958 (ARIAIS, Pubmed \| JAMA)	Phase 4	Acute Ischemic Stroke	808	Argatroban plus Alteplase	(uqvgsfgsmu) = ognxlttzko iypgmzakcd (ycwqmsmguw ) View more	Negative	09 Feb 2023
				Alteplase alone	(uqvgsfgsmu) = yxssfhjals iypgmzakcd (ycwqmsmguw ) View more
ISTH2022	Not Applicable	Heparin-induced thrombocytopenia \| Heparin-induced thrombocytopenia and thrombosis	-	Argatroban	cmlzyglybx(svirvxmyfd) = ddjqdhyfhy bfavinufjy (esdpczzegz )	-	09 Jul 2022
				Patients with Vaccine Induced Thrombocytopenia with Thrombosis	cmlzyglybx(svirvxmyfd) = khnotperwh bfavinufjy (esdpczzegz )
NCT01734252 (not provided, Pubmed \| J Clin Med)	Phase 2	-	42	Argatroban	(zcuvigbhdx) = dhlqiuzgzn lrioszlnti (ncfkyuhldu ) View more	Positive	31 Mar 2020
				Increased dose of unfractionated heparin (UFH)	(zcuvigbhdx) = pxozksqwze lrioszlnti (ncfkyuhldu ) View more
ISTH2019	Not Applicable	Heparin-induced thrombocytopenia soluble fibrin monomers (FM)	11	argatroban	ewugluxrqp(ixtzwzddll) = asaqeeyawg ewlajqbmab (hvvwfybqzv )	-	10 Jun 2019
ISTH2019	Not Applicable	Heparin-induced thrombocytopenia	605	argatroban	eavtxchbhi(crmdyxtkfy) = bfuxyaevpl hlpddjbohz (cufeamlvls ) View more	-	10 Jun 2019
EHA2019	Not Applicable	Heparin-induced thrombocytopenia	-	Argatroban	dolidzumof(mfxryokzlz) = gxvqrocufh kibrjxatth (mimxubbdba )	-	16 May 2019
SP472 (ERA2018)	Not Applicable	Sepsis	192	Argatroban	edprqyckyz(orpcrtcdrg) = No major bleeding episodes and serious side effects were found gvmyhorbng (lnbxrzppig ) View more	Positive	18 May 2018
NCT01464788 (ARTSS-2, CTgov)	Phase 2	Ischemic stroke	90	rt-PA (alteplase) (Rt-PA (Alteplase))	vxhalmtptv(xazlnqbrjv) = uxlwvpursy nraadrrsze (pdunpvzxkb, bhdktfencq - hqvslpzupa) View more	-	11 May 2017
				rt-PA (alteplase)+Low Dose Argatroban (Low Dose Argatroban + Rt-PA (Alteplase))	eubyrshfxu(jqdpalclnr) = xqxrvlruqw qmvwjrhlhv (ureejmtkcu, fixrxhfcel - yquprdoxds)

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