Duteplase, a nearly pure double-chain recombinant tissue-type plasminogen
activator (rt-PA), was introduced in Japan for the treatment of acute
myocardial infarction. Similar to other thrombolytic agents, duteplase acts by
converting the proenzyme plasminogen to the active enzyme plasmin, resulting in
fibrinolysis and varying degrees of depletion of circulating fibrinogen, factor V and
factor VIII. In patients with acute myocardial infarction, treatment with duteplase
induced patency rate of infarct-related artery at 90 minutes by up to 69%. Compared
with alteplase, a single-chain rt-PA, duteplase has similar activity but a slower
clearance rate and thus lower doses of duteplase have a similar therapeutic effect to alteplase.
