Urokinase for Thrombolysis in Acute Ischemic Stroke

Summary

According to the Chinese Guidelines for the Diagnosis and Treatment of Ischemic Stroke, intravenous thrombolysis with urokinase, administered at doses of 1-1.5 million IU within 6 hours of symptom onset, has been shown to be both safe and effective for patients with acute ischemic stroke. Compared to alteplase, urokinase offers considerable cost advantages while maintaining comparable therapeutic efficacy. However, current dosing protocols in clinical practice largely rely on the empirical judgment of physicians rather than evidence-based standardization. Therefore, the development of a weight-adjusted dosing regimen for urokinase is of significant clinical importance in optimizing treatment outcomes and ensuring patient safety. The purpose of this study is to determine the maximum tolerated dose of urokinase thrombolytic treatment in patients with acute ischemic stroke and to develop an optimal weight-adjusted dosing regimen.

Timeline

Start

2025-10-01

Primary completion

2026-10-02

Completion

2027-01-02

Publications

• Wang S, Ma Q, Ji X, Zhao W, Wu L. Urokinase for thrombolysis in patients with acute ischemic stroke: rationale and design of a phase I dose-escalation study. Front Neurol. 2026 Apr 15;17:1750720. doi: 10.3389/fneur.2026.1750720. eCollection 2026.

Drugs

Indications