Canadian researchers identify a new weapon against ischemic stroke

Jean-Benoit Legault, The Canadian Press

MONTREAL — A drug already commonly used to dissolve clots during heart attacks is also effective in fighting the clots responsible for ischemic strokes, shows one of the largest clinical trials ever conducted in Canada.

The study published in the prestigious medical journal The Lancet and to which researchers from Montreal, Ottawa, Toronto and Calgary contributed in particular, claims that tenecteplase was found to be just as effective, if not more effective, than the drug currently recommended during an ischemic stroke, alteplase.

Both drugs have the effect of activating enzymes produced by the human body to dissolve clots.

“It’s a Canadian medical success story, because it’s really only Canadian centers that participated in this study,” said one of the study’s authors, Dr. Alexandre Poppe, who is a neurologist in particular. vascular at the CHUM.

Some 1,600 patients from across Canada participated in this clinical trial. Half of them received tenecteplase and the other half alteplase, randomly.

In fact, tenecteplase binds to the clot longer than alteplase, which means that blood flow to the brain is restored more quickly and for a longer period of time.

Tenecteplase is also easier and faster to administer than alteplase, which is a major advantage when trying to save brain cells from death.

Every minute that the brain is deprived of oxygen leads to the disappearance of 1.9 million neurons, pointed out Dr. Poppe.

“Every second counts,” he said. If we can administer the drug more quickly because there is no infusion, we can save time in this sense.

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For example, tenecteplase can be administered in a single dose, while administration of alteplase can take up to an hour and requires an infusion pump that requires nurse supervision and may be cumbersome if the patient should be referred to another center.

Tenecteplase would finally have shown itself to be a little more effective in dissolving the large clots that the enzymes struggle to eliminate by themselves.

“I can say that we are not the first to think of this possibility, because other studies have been done before this one, said Dr. Poppe in conclusion. But this one stands out because it’s really big and I think it’s the strongest evidence we have.”

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