Effects of alteplase for acute stroke on the distribution of functional outcomes

They still don't bother to tell you that tPA getting to full recovery has a horrifying 88% failure rate. Damn I hate these 'happy talk' research articles. Because of this fucking 'happy talk' no one is looking for a better replacement.
http://www.mdlinx.com/internal-medicine/medical-news-article/2016/08/23/confidence-interval-odds-ratio-stroke-thrombolytic/6828728/?

Stroke, 08/23/2016Lees KR, et al.

The clinicians intended to evaluate the effects of alteplase for acute stroke on the distribution of functional outcomes. The study reveal that treatment with intravenous alteplase started within 4.5 hours of stroke onset increases the chance of achieving an improved level of function for all patients across the age spectrum, including the over 80s and across all severities of stroke studied; the earlier that treatment is initiated, the greater the benefit.

Methods

• From 9 randomized trials, prespecified pooled analysis of 6756 patients comparing alteplase vs. placebo/open control.
• For this study, ordinal logistic regression models assessed treatment differences after adjustment for treatment delay, age, stroke severity, and relevant interaction term(s).

Results

• Treatment with alteplase was favourable for a delay in treatment extending to 4.5 hours after stroke onset, with a greater benefit with earlier treatment.
• The study reveal that, neither age nor stroke severity significantly affected the slope of the relationship between benefit and time to treatment initiation.
• As per the study, for the observed case mix of patients treated within 4.5 hours of stroke onset (mean 3 hours and 20 minutes), the net absolute benefit from alteplase (ie, the difference between those who would do better if given alteplase and those who would do worse) was 55 patients per 1000 treated (95% confidence interval, 13–91; P=0.004).