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A group of researchers have made a “breakthrough” in stroke treatment that could benefit thousands of Canadians who suffer from strokes every year.
Researchers from the Sunnybrook Health Sciences Centre, the University of Toronto and the University of Calgary have found that a drug used to treat heart attacks is also effective at treating the most common type of stroke.
The two-year study included 1,600 patients at hospitals across the country and is the largest stroke clinical trial that's ever been run in Canada.
The study, which was published in the British medical journal The Lancet, shows that the drug Tenecteplase (TNK) — which is used to treat heart attack patients — is an effective treatment for acute ischemic stroke.
The reason it’s marking a milestone in stroke research is that TNK is not only more cost-effective, but also faster to administer to stroke patients compared to the current treatment.
“Our study findings have the potential to transform the current standard of care of stroke across Canada and around the world,” Dr. Rick Swartz, a co-principal investigator of the study and stroke neurologist at Sunnybrook says in a news release. “This could mean faster treatment and the potential for improved outcomes for stroke patients.”
What is an acute ischemic stroke?
Ischemic strokes, which are the most common type of strokes, happen when blood supply is cut off to part of the brain, resulting in damage to brain cells.
According to the Journal of the American Medical Association (JAMA), ischemic strokes should be treated as soon as possible for a better outcome.
Swartz tells Yahoo Canada that for nearly 30 years, the standard treatment for acute ischemic stroke has been Alteplase (tPA), a clot-busting drug which takes up to an hour to administer, requires an infusion pump and needs to be monitored by health professionals.
TNK is easier and faster to administer
During their study, researchers determined that TNK lasts longer in the body than tPA, dissolving clots and helping to restore blood flow to the brain.
“The key measure of the difference between the two, we showed that TNK, overall, gives two per cent more good outcomes, excellent outcomes, to people recovering back to normal compared to Alteplase,” Swartz tells Yahoo Canada.
Not only does it provide better outcomes, but the one-time treatment of TNK is also easier to administer than Alteplase with a simple injection that begins working much faster.
“We don’t need as much tubing, we don’t need pumps, we don’t need nurses to monitor the infusions the same way,” Swartz explains.
The findings of this study won’t just benefit Canadians, but people right across the world.
That’s because there are many places in the world “where TNK is significantly cheaper than Alteplase,” Swartz explains.
“Anywhere where healthcare is strapped, which as you know, definitely includes Canada these days, any little bit that we can do to ease up on the nurses, free them up to do something else, is important,” he adds.
The stroke neurologist also highlights the importance of getting the dosage right when you’re using TNK for stroke versus when you’re using it to treat heart attack patients.
He says TNK is currently available in a 0.5-milligram dosage to treat heart attacks, which is double the dose of 0.25, which is what researchers used during the study to treat strokes.
Time is extremely important
When it comes to stroke patients, every minute counts.
The Public Health Agency of Canada says it’s important for everyone to learn the signs of stroke.
For years, the FAST acronym has been used to teach people the different symptoms of a stroke, which includes facial drooping, arm weakness, speech difficulties and time.
Swartz advises people to call 911 as soon as they begin experiencing symptoms because “every 15 minutes makes a measurable difference in outcomes.”
"If we get there very early, in the first few hours of the clot happening within a few hours of the symptoms presenting, we have medication that we use to try to dissolve the blood clot and restore blood flow to the brain," he says. "When we do that, we use the term 'time is brain' because every minute while that blood flow is blocked, brain cells die."
As for what’s next, the stroke neurologist expects the guidelines in Canada and the United States to be adjusted soon to show TNK as another option for stroke treatment.
“The simple switch that is already easier and, system-wise, so much more efficient, it is likely that we may be helping a few more people, which is great because there are thousands of strokes treated every year across Canada, and so every one person we can help get a little better is a victory,” he says.