Tian DC, et al. - In acute ischemic stroke patients in a delayed time window, researchers tested the effectiveness of co-administration of fingolimod with alteplase. Study participants included those with an internal carotid artery or middle cerebral artery proximal occlusion within 4.5-6 hours from symptom onset. The results obtained from this prospective, randomized, open-label, blinded endpoint clinical trial indicated that fingolimod may enhance the effectiveness of alteplase administration in the 4.5- to 6-hour time window in those with a proximal cerebral arterial occlusion and salvageable penumbral tissue by promoting both anterograde reperfusion and retrograde collateral flow. Researchers noted that study participants who received fingolimod and alteplase showed a greater decline in the perfusion lesion accompanied by suppressed infarct growth by 24 hours.