Talk:Alteplase

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Thinking of adding a "controversies section" The use of alteplase, particularly in the context of acute ischemic stroke, has a history of controversy. Concerns have been aired about potential financial conflicts of interest between The American Heart Association and the manufacturer of alteplase. — Preceding unsigned comment added by Mitchell.mcelroy (talk • contribs) 20:24, 30 October 2020 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 15 September 2020 and 7 December 2020. Further details are available on the course page. Student editor(s): Rin1725, Abbysaunders, Igarnish.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 17:09, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 October 2020 and 13 November 2020. Further details are available on the course page. Student editor(s): Mitchell.mcelroy. Peer reviewers: Logan6465.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 17:09, 17 January 2022 (UTC)

Planned work October 2020

UCF COM Wiki Project Medicine Workplan

Hello, I will be working on this article for about the next month.

My Goals are.

1. Introduce a Indication-Contraindication section.
2. Make a more robust discussion over the History of the use of this medicine.
3. More organization to the Adverse Effects profile of the drug in other patient groups.
4. Once these are fixed, I may go more into details of the mechanism of action and pharmacology

--Mitchell.mcelroy (talk) 20:22, 22 October 2020 (UTC)

User:Mitchell.mcelroy - welcome! I encourage you to look through the "Manual of Style" for medicine related articles, specifically this section regarding the typical section headings for an article. I think your work will be great and please feel free to ping myself or anyone else if you have any questions regarding guidelines on Wikipedia. You can ping someone by pasting {{ping|username}} followed by your comment and then ~~~~ to sign your post. -bɜ:ʳkənhɪmez (User/say hi!) 20:34, 22 October 2020 (UTC)

User:Mitchell.mcelroy Looking forward to improving this page together as Wiki Project students, feel free to reach out to us @Abbysaunders:@Igarnish:@Rin1725: for any questions or concerns! Rin1725 (talk) 14:34, 27 October 2020 (UTC)Rin1725

Deleted "Alteplase is a manufactured form of tissue plasminogen activator. It works by converting plasminogen to plasmin in a blood clot." — Preceding unsigned comment added by Mitchell.mcelroy (talk • contribs) 20:54, 26 October 2020 (UTC)

Wiki Project 2020

Hi! We are students from McMaster University, and we aim to help edit and expand the Wikipedia Alteplase page during the next few months.

Goals:

• Expand on the Medical Uses section by creating subsections dedicated to STEMI, acute ischemic stroke, pulmonary embolism, and blocked catheters, as well as subsections on side effects and contraindications
• Expand on the Society and Culture section, add information on how Alteplase was recently included in the WHO Model List of Essential Medicine
• Create a new Safety section by referring to recent review articles on Alteplase’s safety and efficacy for each indication

Our Team: @Abbysaunders: @Igarnish: @Rin1725:

Rin1725 (talk) 14:22, 27 October 2020 (UTC)Rin1725

→Welcome, I would really appreciate your input on the adverse effects section as well. Bleeding is obvious, but there seems to be very little secondary literature on any other adverse effects. Additionally, I am looking to add some images, but I am having trouble finding useful images without CC. Any thoughtsMitchell.mcelroy (talk) 22:50, 27 October 2020 (UTC)

→→I see that you have ordered contraindications into its own category. The reason I had those apart for each medical use was because the contraindications are in fact different for each medical use. Let me know what you think.2001:48F8:9:14F2:511C:4565:F971:FF3D (talk) 18:33, 30 October 2020 (UTC)

I am the one who reordered it :) It is redundant to list the contraindications separately. When listed separately, 'active bleeding' could be listed 3+ times depending on how many indications there are. Per WP:MEDMOS, the uses should be one coherent section, and the contraindications should be all in one section.

I recommend writing paragraphs (prose) for the contraindications that are indication specific - describe why they are contraindications for the specific uses but not for other uses, etc - and keep the "universal contraindications" (ex: active bleeding) in a list format. Regards, -bɜ:ʳkənhɪmez (User/say hi!) 18:38, 30 October 2020 (UTC)

I have modified the list of contraindications to be general contraindications and added a later sentence for contraindications specific to use for acute ischemic stroke. Hope this is along the lines of what you had suggested! Abbysaunders (talk) 00:39, 3 November 2020 (UTC)

Abbysaunders, yes definitely so - I think it works better this way and allows the list to remain while still providing some "prose" (or sentence format) explanation of them. Thank you for your work! I'll continue making minor changes/fixes as I see things but all in all it looks like you and everyone working on this article are doing a great job. Please as always feel free to post here or ping me (you can just type ping|berchanhimez - note the | is the vertical pipe character usually found by pressing SHIFT+\ - surrounded by curly brackets {{ }} to ping me anywhere). -bɜ:ʳkənhɪmez (User/say hi!) 00:43, 3 November 2020 (UTC)

UCF COM Peer Review:

Overall: There was a great deal to add to this page and I applaud your detailed work. The first image added is fantastic and clear to understand for readers. The pathway image was also a good choice and simplified. The added sections add depth to the article and the break down is easy to follow. The increased number of hyperlinks is also noticeable and allows the reader to investigate further. Solid use of references as almost every sentence includes at least one. I think you went above and beyond your four main goals in your workplan!

Intro: Clear and concise. It is hard to describe this kind of topic without medical terminology but you did a good job in making it more understandable for a reader that is potentially not in the medical field.

Medical Uses: Appreciate the separate sections for the four main clinical indications.

-Could use a short list of the most common causes of major bleeding after mentioning that in the Ischemic Stroke section or add a “see contraindications” so the reader can get that information immediately after reading that; not necessary since these are mentioned in the contraindications section.

-Second sentence of MI section may read better as “If a person is experiencing a STEMI at a non-PCI capable hospital and cannot be transferred to receive PCI in under 120 minutes, they may be eligible for treatment with alteplase in combination with other drugs.”

-In the end of the second paragraph in the PE section, may want to revise wording for readability (delete the second “that” and leave it, or change it to something like “A systematic review has shown that a low-dose of alteplase is just as effective as the standard amount while also being safer”).

-I don’t think it is clarified that systemic thrombolysis is simply administering the drug via IV. Might be helpful to mention that in the medical uses intro ie “Generally, alteplase is delivered intravenously into the body which is referred to as systemic thrombolysis.

-I really like the bullet point format in the PE section.

Contraindications: The flow is nice. For the last sentence, are you saying if a patient with an AIS has contraindications to Alteplase they may receive other therapies? At first read it wasn’t clear to me what that sentence was describing in relation to contraindications.

Adverse effects: Solid.

MOA: Well stated. It is hard to simplify such a complicated process into this format!

Society and Culture & History: Good.

References: Impressed that every reference is either a website or a journal article with a doi listed!

Logan6465 (talk) 04:15, 11 November 2020 (UTC)

• I would like to thank all the students for working on this article - the vast majority of changes have been useful, accurate, and well formatted. I'd like to personally reach out as there are many articles on medical topics that need the help of "experts" - be they students or other medical professionals - and I'd be happy to mentor you if you wish to continue editing outside of your class. As I'm sure you know, many students and medical professionals use Wikipedia for a quick reference - as do millions of regular people (patients) every day - so ensuring we have correct and complete information is a goal that requires a lot of work. Please do not take the edits myself and others have made to your additions as a sign of any failure - Wikipedia is a collaborative project and ideally all of us have the goal of making it the best it can be. Aside from one issue which I feel was an honest mistake, I have not seen any bad faith edits here from the students - and I want you to know that your work is much appreciated - even though I'm sure your primary concern is the classwork. Please feel free to email me through Wikipedia if you desire communication as to how to become editors outside this one article - because myself and others in the "WikiProject" devoted to medicine and that dedicated to pharmacology would be grateful to have your help in other articles as well. At this time, I agree with this review and have nothing major to add. Regards, -bɜ:ʳkənhɪmez (User/say hi!) 02:51, 14 November 2020 (UTC)

Article class

I've just changed the article class under WikiProject Medicine from Start to B. This is in light of the significant changes that myself, my groupmates, and @Mitchell.mcelroy: have added over the past several weeks, and after a discussion with our instructor. If there are any issues with this, please let me know. Igarnish (talk) 01:04, 17 November 2020 (UTC)

I was just about to update it to C, but not because I disagree with the B classification but moreso because I believe in stepwise addition. I agree that it is not inappropriate to label it as B now, and I reiterate my thanks for your work on this article and encourage you to expand to other articles either now or after you finish this course. -bɜ:ʳkənhɪmez (User/say hi!) 02:12, 17 November 2020 (UTC)

FDA Licensure details

Hi, Whywhenwhohow — I'd like to discuss a bit the in/exclusion of the FDA licensure content details. I see significant parallels with GA-status articles that likewise detail regulatory approval; see e.g. Adderall#History, which has a rather extensive discussion thereof. At the very least, it is well established that FDA approval is worth mentioning — see GAs Rabeprazole#History and Metformin#History and FA Linezolid#History. In the case of Alteplase (Activase), the unexpected delay in the approval process spawned a specific editorial in one of the country's most prominent newspapers, which in turn generated coverage in another extremely prominent newspaper, and was subsequently detailed in a book. That is three instances of significant coverage in RS that discuss the incident. I am having difficulty seeing how the two sentences removed in Special:Diff/1142774386 are WP:UNDUE. WhinyTheYounger (WtY)(talk, contribs) 23:17, 4 March 2023 (UTC)

Approval is relevant for this article and is already discussed in the Legal status section. The other actions and reactions by the newspaper and the stock market might be appropriate for an article about Genentech. --Whywhenwhohow (talk) 23:22, 10 March 2023 (UTC)

Thanks for your reply. I disagree. I think it certainly could warrant inclusion in the Genentech article, but that does not mean it belongs exclusively there. I believe the burden falls on you to provide a specific line in policy, guidelines, or MOS to explain why a facet of the drug's approval documented in three RS is inappropriate. My metric here is WP:PRESERVE: As long as any of the facts or ideas added to an article would belong in the "finished" article, they should be retained if they meet the three core content policies... — so unless the text is undue (slash trivial), non-neutral, or original research, then I see it as entirely worth inclusion. WhinyTheYounger (WtY)(talk, contribs) 00:58, 12 March 2023 (UTC)

(Note: I found an additional source, Science, that devoted an entire article to the delayed approval: Sun, Marjorie (3 July 1987). "FDA Puts New Heart Drug on Hold: A surprise decision by the FDA to withhold approval of TPA, a potent clot-dissolving drug, highlights a scientific debate among cardiologists". Science. 237 (4810): 16–18.. A subsequent article by the same author also devoted several paragraphs to Activase's unexpected delay: Sun, Marjorie (20 November 1987). "New Data Clinch Heart Drug Approval". Science. 238 (4830): 1031. In short, then, there is detailed coverage of this aspect of Activase's approval in numerous reliable sources, and that coverage and discussion thereof extends past the event itself. WhinyTheYounger (WtY)(talk, contribs) 01:23, 12 March 2023 (UTC)