Bat-tling stroke: bat’s derived molecules for therapeutic use, a systematic review and meta-analysis of desmoteplase and an indirect comparative analysis with the current therapy for stroke.

Stroke remains one of the leading causes of death and disability worldwide. Despite advances in pharmacological therapies, current options remain limited. Alteplase (rt-PA) is the standard thrombolytic agent, but it has limitations in efficacy, particularly beyond narrow therapeutic windows (0 to 4.5 hours from symptoms onset) and for LOVs, and safety, as it increases the risk for ICH. Only one in three patients manages to reach the hospital in time for the thrombolysis therapy, and even then, complete recovery is not guaranteed. In this context, growing interest has emerged around the development of new thrombolysis agents, possibly with a broader therapeutic window and an improved safety profile. This thesis aimed to evaluate the efficacy and safety of desmoteplase (vampire bat-derived t-PA) in acute ischemic stroke through a systematic review and meta-analysis of clinical studies. Additionally, an indirect comparison with rt-PA using Bucher’s method was conducted. This work provides an in-depth evaluation of desmoteplase as a therapeutic option, contributing valuable insights for clinical practice and future stroke research.