Recently, the China Medical Development Conference was held in Beijing, at which the Chinese Academy of Medical Sciences released the "Important Medical Achievements of China in the 21st Century" and "Important Medical Progress in China in 2023". Among them, 3 research achievements in the field of cerebrovascular diseases were selected into the "Important Medical Advances in China in 2023". The research results of the clinical trial of early terofiban treatment of acute non-large and medium vaso-occlusive stroke (RESCUE BT2 trial) conducted by the team of Professor Yang Qingwu of the Second Affiliated Hospital of the Army Medical University and Lunan Pharmaceutical Group were successfully listed in the "Important Medical Progress in China in 2023". The research was published in The New England Journal of Medicine IF (158.8 points) as a cover article. Studies have found that tirofiban can effectively treat acute stroke, significantly improve the prognosis of patients, and reduce the disability rate of patients with acute non-large and medium vaso-occlusive disabling stroke. In terms of safety, there was no significant difference in mortality and thrombus escape ratio between patients treated with tirofiban compared with the aspirin group.
Stroke is an acute cerebrovascular disease, which is one of the main diseases that threaten the health of mainland citizens with high morbidity, high recurrence rate, high disability rate, high mortality rate and high economic burden. Timely and effective rescue is essential to improve patient outcomes. For patients with acute stroke within 4.5 hours of onset, it is important to choose the appropriate treatment strategy.
Based on the current status of stroke treatment, Professor Yang Qingwu's team led the RESCUE BT2 study to evaluate the efficacy and safety of tirofiban and low-dose oral aspirin in patients with acute ischemic disabling stroke with non-large and medium vascular occlusion. A total of 1177 patients from 117 stroke centers in 16 provinces (autonomous regions and municipalities) were randomly assigned to either tirofil group (606 cases) or aspirin group (571 patients) in a 1:1 ratio.
The results of the trial showed that 29.1% and 22.2% of the patients in the tirofilab group and aspirin group met the primary efficacy endpoint (90-day mRS score 0~1 points), respectively, and there was a statistically significant difference between the two groups (adjusted relative hazard ratio 1.26; 95% CI, 1.04~1.53, P=0.02). Studies have shown that tirofiban can significantly reduce the disability rate and improve functional outcomes.
In terms of safety outcomes, the rate of symptomatic intracranial hemorrhage in the tirofil group was slightly higher than that in the aspirin group (1% vs. 0.0%, P=0.03). There was no difference between 90-day mortality and thrombus escape.
The release of this result confirmed the clinical value and advantages of tirofiban, and finally confirmed that intravenous tirofiban treatment can significantly reduce the disability rate of patients with acute non-large and medium vaso-occlusive disabling stroke compared with traditional treatment methods, providing a new treatment for the treatment of patients.
Tirofiban
Tirofiban is an excellent antiplatelet drug produced by Lunan Betle Pharmaceutical Co., Ltd., a subsidiary of Lunan Pharmaceutical Group, which is a highly selective non-peptide platelet glycoprotein IIb/IIIa receptor antagonist, which can reversibly inhibit platelet aggregation. At present, it has been widely used in the treatment of coronary arteriosclerotic heart disease, percutaneous coronary intervention and stroke. Tirofiban has been recommended by many authoritative guidelines/consensuses, such as the Chinese Guidelines for the Endovascular Treatment of Acute Ischemic Stroke 2023, the Expert Consensus on the Clinical Application of Tirofiban in Atherosclerotic Cerebrovascular Diseases, the Chinese Expert Consensus on Perforated Atherosclerosis Disease, and the Chinese Guidelines for the Diagnosis and Treatment of Unruptured Intracranial Aneurysms 2021, and is widely used in clinical practice.
参考文献：Zi W, Song J, Kong W, et al. Tirofiban for Stroke without Large or Medium-Sized Vessel Occlusion. N Engl J Med. 2023; 388(22):2025-2036.
Source: Lunan Pharmaceutical Group WeChat public account