Saruplase

Saruplase has been evaluated in several trials in patients with acute MI or unstable angina. The Comparison Trial of Saruplase and Streptokinase (COMPASS), the largest of saruplase trials, attempted to demonstrate the equivalence of saruplase to streptokinase in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). Patients were randomly assigned to receive heparin and saruplase (20 mg i.v. bolus followed by 60 mg i.v. over the next 60 min) or streptokinase without heparin. Saruplase was associated with a reduction in mortality compared to streptokinase. Patients treated with saruplase were also less likely to develop hypotension, but more likely to develop hemorrhagic stroke than those treated with streptokinase (0.9% versus 0.3%). The overall bleeding rates between the two treatment groups were similar (10.4% versus 10.9%). These findings suggested that saruplase is as effective as streptokinase in the treatment of acute STEMI, with a similar safety profile.73

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