Lanoteplase.

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.