'Difference between paralysis and walking out of the hospital': U of C research offers stroke treatment hope
CALGARY -- The experimental drug nerinetide has been shown to dramatically improve the outcome for patients suffering the most common type of stroke.
Ischemic strokes are often treated with the clot busting drug alteplase — commonly referred to as TPA —followed by endovascular treatment (EVT) to remove the clot.
The research led by a team from Calgary’s Cumming School of Medicine, and the Hotchkiss Brain Institute, tested two scenarios. In the first, nerinetide was given as well as TPA , and in the second patients who were not suitable for TPA received only the nerinetide. Both groups still received the endovascular clot removal.
"Almost 20 per cent more patients who received nerinetide along with endovascular treatment, but did not receive alteplase, recovered from a devastating stroke – a difference between paralysis and walking out of the hospital," said Dr. Michael Hill, MD, a neurologist at the Foothills Medical centre and a professor in clinical neurosciences at the Cumming School of Medicine . "In the patients who received both drugs, the alteplase negated the benefits of the nerinetide."
Nerinetide targets the final stage of the brain cell’s life by stopping the production of nitric oxide within the cell.
According to Hill, the study shows researchers a biological pathway protecting brain cells preventing brain cell death when they are deprived of blood flow.
"We really believe this is a new scientific observation," said Hill. "There is evidence nerinetide promotes brain cell survival, offering neuroprotection until we can extract the clot. It opens the door to a new way of treating stroke."
Every nine minutes someone in Canada has a stroke. Ischemic strokes, the most common type of strokes, are caused a clot in a blood vessel in the brain which prevents blood flow resulting in the death of brain cells. Survivors often suffer permanent impairments to speech, vision, balance and movement.
"After so many studies investigating neuroprotective drugs failed, we are extremely excited by these results," said Dr. Mayank Goyal, MD, PhD, a neuroradiologist at Calgary's Foothills Medical Centre. "While nerinetide is not approved for use yet, it shows the potential of a new tool to promote recovery from stroke."
More than 1,100 patients were involved in the current research , which took place between March 2017 and August 2019 in 48 stroke centres in North America, Europe, Australia, and Asia. The study builds on the results of earlier research in which the Calgary Stroke Program proved that EVT dramatically improves patient outcome after and ischemic stroke.