Alfimeprase: a novel recombinant direct-acting fibrinolytic

Abstract

Alfimeprase is a recombinant, direct-acting fibrinolytic zinc metalloprotease. Alfimeprase has direct proteolytic activity primarily against the fibrin(ogen) Aα chain. Alfimeprase is covalently bound and neutralised by serum α₂-macroglobulin, a prevalent mammalian protease inhibitor. Preclinical pharmacology studies have shown that fibrinolysis with alfimeprase is up to sixfold more rapid than with select plasminogen activators, such as tissue-type plasminogen activator and urokinase. Alfimeprase directly delivered to a site of thrombosis has the potential to be a fast and effective fibrinolytic, which does not generate the systemic lytic state seen with plasminogen activators that is associated with major bleeding, including intracerebral haemorrhage. Phase I and II studies in individuals with arterial or venous thrombotic events indicate that alfimeprase is active and generally well tolerated.

Keywords::

• alfimeprase
• fibrinolysis
• plasminogen activator
• thrombolysis
• thrombosis

Acknowledgements

Financial disclosure: the authors are or have been employees of companies that have a financial interest in alfimeprase.

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