In the largest stroke clinical trial ever conducted in Canada, researchers showed that Tenecteplase (TNK), a safe, well-tolerated drug commonly used as a means of destroying clots in heart attacks, is an effective treatment for acute ischemic stroke. Led by researchers from the University of Calgary at Foothills Medical Center and the Sunnybrook Center for Health Sciences, which is fully affiliated with the University of Toronto, the study included 1,600 patients in hospitals across Canada.
“It is a really important discovery that I am sharing with my colleagues from coast to coast. Through this collaboration, these discoveries could revolutionize the treatment of stroke worldwide, ”said Dr. Bijoy Menon, MD, professor at the University of Calgary, neurologist at Foothills Medical Center and principal investigator of the study. “Tenecteplase is known to be an effective drug for dissolving clots. It’s very easy to administer, which makes it change the game when seconds are counted to save brain cells. “
Based on current guidelines, Alteplase (tPA) is the recommended drug for patients with acute ischemic stroke. The challenge is that the drug is more complicated to administer. It takes up to an hour and requires an infusion pump, which must be monitored. The pump can be cumbersome when transporting a patient to a hospital or to a large stroke treatment center.
“One of the reasons Tenecteplase is so effective is that it can be given as a single immediate dose,” said Dr. Rick Swartz, MD, PhD, a research clinician at the University of Toronto, principal investigator and stroke neurologist at the Center for Stroke. health sciences Sunnybrook. “This is a great advantage, saving critical time and complication. TNK can potentially be administered wherever the patient is first seen, in a medical center or small hospital.
The ActT study compared TNK with tPA in a randomized study. The results, published in The Lancet, show that TNK worked just as well, if not better, than the current recommended drug, tPA. TNK attaches to the clot for a longer period of time than tPA, which means that blood flow is restored faster and for a longer period of time. Along with finding a better way to treat acute ischemic stroke, the team also found a more cost-effective and efficient way to conduct clinical trials.
reference: Menon BK, Buck BH, Singh N, et al. Intravenous tenecteplase versus alteplase for acute ischemic stroke in Canada (AcT): pragmatic, multicenter, open, registry-related, randomized, controlled, non-inferior study. The lancet. 2022; 0 (0). doi: 10.1016 / S0140-6736 (22) 01054-6
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