Vol. 2 No. 9 (2022)

Letter to the Editor Regarding CADTH Rapid Review: Systemic Thrombolysis by Alteplase for Acute Ischemic Stroke

Published September 12, 2022

Key Messages

The Canadian Stroke Consortium read with interest the recent rapid review by CADTH on the evidence of alteplase for acute ischemic stroke. We felt it necessary to reply for several reasons:

  • despite the 27-year history of alteplase since the NINDS publication, the rapid review limits the search to the last 6 years, which does not reflect the totality of the evidence,
  • the process for inclusion of studies was questionable, leading to a strongly biased representation of the existing literature, and
  • important concerns from the single expert reviewer were not adequately addressed prior to publication.