Heart attack drug proves effective in treating stroke

In the largest clinical trial of stroke ever conducted in Canada, researchers have shown that Tenecteplase (TNK), a safe, well-tolerated drug, often used as a clot breaker for heart attacks, is an effective treatment for acute ischemic stroke. Led by researchers from the University of Calgary at the Foothills Medical Center and Sunnybrook Health Sciences Center, wholly affiliated with the University of Toronto, the study included 1,600 patients in hospitals across Canada.

“It’s a really important finding that I share with my colleagues from coast to coast. Through this collaboration, these findings could revolutionize stroke treatment around the world,” said Dr. Bijoy Menon, MD, professor at the University of Calgary, neurologist at Foothills Medical Center and co-principal investigator of the study. “Tenecteplase is known as an effective clot-dissolving agent. It’s very easy to administer, making it a game changer when seconds count to save brain cells,”

Based on current guidelines, Alteplase (tPA) is the drug of choice for patients with acute ischemic stroke. The challenge is that the drug is more complex to administer. It takes up to an hour and requires an infusion pump to be monitored. The pump can be cumbersome when transporting a patient within a hospital or to a major stroke center for treatment.

“One of the reasons Tenecteplase is so effective is that it can be administered as a single immediate dose,” says Dr. Rick Swartz, MD, PhD, clinician researcher at the University of Toronto, co-principal investigator and stroke neurologist at Sunnybrook Health Sciences Center. “That’s a big advantage, it saves critical time and complications. TNK could potentially be administered wherever the patient is first seen, in a medical center or small hospital.”

The AcT Trial compared TNK to tPA in a randomized trial. The results published in the lancet showed that TNK worked as well, if not better, than the currently recommended drug, tPA. TNK adheres to the clot for a longer time than tPA, restoring blood flow faster and for longer. In addition to discovering a better way to treat acute ischemic stroke, the team has also developed a more cost-effective and efficient way to conduct clinical trials.

Reference: Menon BK, Buck BH, Singh N, et al. Intravenous tenecteplase compared with alteplase for acute ischemic stroke in Canada (AcT): a pragmatic, multicenter, open-label, registry-linked, randomized, controlled, non-inferiority study. the lancet† 2022;0 (0). doi: 10.1016/S0140-6736(22) 01054-6

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