Alteplase treatment reduces long-term disability and improves quality of life in stroke survivors

June 20, 2013, Lancet

New research published Online First in The Lancet Neurology indicates that giving the clot-busting drug alteplase up to 6 hours after a stroke reduces long-term disability, significantly increases the likelihood of independence, and improves quality of life in stroke survivors of all ages for up to 18 months after treatment.

The latest results from the third International Stroke Trial (IST-3) suggest that the drug has the potential to cut costs by reducing the demand for long-term care.

Treatment for (in which to an area of the brain is blocked or reduced) with alteplase (recombinant tissue plasminogen activator; rtPA) is approved in Europe for patients younger than 80 years within 4.5 hours of . Currently, fewer than 15% to 40% of people arrive at the hospital within this treatment window, and only 2% to 5% of suitable patients receive thrombolysis with alteplase.

In 2012, the IST-3 involving 3035 patients (half older than 80 years of age) from 12 countries, reported that those randomly assigned to alteplase treatment within 6 hours of stroke onset had reduced disability at 6 months compared with those who did not receive the drug.

Here, the IST-3 Collaborative Group report the survival, functional outcome, health-related quality of life, and living circumstances of nearly four fifths (2348 patients) of participants from 10 countries at 18 months.

Although treatment had no effect on survival at 18 months, the odds of being alive and independent were 28% greater for patients given alteplase.

What is more, participants given alteplase reported significantly fewer problems with long-term mobility, self-care, pain and discomfort, and "needing help with ".

According to lead author Peter Sandercock from the University of Edinburgh's Division of Clinical Neurosciences, "In the UK in 2002, the estimated annual cost of long-term care of an independent survivor of stroke and a dependent survivor were £876 and £11 292 respectively, so even a small difference in the proportion of survivors who are able to look after themselves will have substantial economic impact."

Commenting on the paper, Craig Anderson from The George Institute for Global Health at the University of Sydney, Australia writes, "I commend the IST-3 investigators for providing a more comprehensive, patient-centred approach to assessment of the effects of alteplase on quality of life than has previously been done. Assessment of health-related quality of life helps the interpretation of outcomes and is an important part of decision-making about efficacy of treatment that accounts for the patients' perspective."

Explore further: Who will benefit from stroke drug? New score can help decide

More information: www.thelancet.com/journals/lan … (13)70130-3/abstract

Related Stories

Who will benefit from stroke drug? New score can help decide

February 6, 2012
A new scoring method can help doctors quickly decide which stroke patients will respond well to the clot-busting drug alteplase, according to a study published in the February 7, 2012, print issue of Neurology, the medical ...

Tenecteplase drug bests standard treatment for certain strokes

March 22, 2012
(HealthDay) -- A medication called tenecteplase may be more effective at treating strokes caused by clots in large blood vessels in the brain than the current standard therapy, Australian researchers report.

Mobile stroke unit roughly halves time to diagnosis and treatment of patients with suspected stroke

April 10, 2012
Using a specialised ambulance or mobile stroke unit (MSU) to assess and treat patients who have had a suspected stroke at the site of the emergency roughly halves the time from the initial call for help to treatment decision, ...

World's biggest stroke clot-buster trial reveals patient benefits

May 24, 2012
(Medical Xpress) -- Patients given a clot-busting drug within six hours of a stroke are more likely to make a better recovery than those who do not receive the treatment, new research has found.

Earlier treatment following stroke linked with reduced risk of in-hospital death

June 18, 2013
In a study that included nearly 60,000 patients with acute ischemic stroke, thrombolytic treatment (to help dissolve a blood clot) that was started more rapidly after symptom onset was associated with reduced in-hospital ...

Timely treatment after stroke is crucial, researchers report

June 19, 2013
For years, the mantra of neurologists treating stroke victims has been "time equals brain." That's because getting a patient to the emergency room quickly to receive a drug that dissolves the stroke-causing blood clot can ...

Recommended for you

Classifying brain microglia: Which are good and which are bad?

December 6, 2018
Microglia are known to be important to brain function. The immune cells have been found to protect the brain from injury and infection and are critical during brain development, helping circuits wire properly. They also seem ...

Drawing is better than writing for memory retention

December 6, 2018
Older adults who take up drawing could enhance their memory, according to a new study.

Friend or foe? Brain area that controls social memory also triggers aggression

December 5, 2018
Columbia scientists have identified a brain region that helps tell an animal when to attack an intruder and when to accept it into its home. This brain area, called CA2, is part of the hippocampus, a larger brain structure ...

How the brain hears and fears

December 5, 2018
How is it that a sound can send a chill down your spine? By observing individual brain cells of mice, scientists at Cold Spring Harbor Laboratory (CSHL) are understanding how a sound can incite fear.

Adding new channels to the brain remote control

December 5, 2018
By enabling super-fast remote control of specific cells, light-activated proteins allow researchers to study the function of individual neurons within a large network—even an entire brain. Now one of the pioneers of 'optogenetics' ...

Microbial-based treatment reverses autism spectrum social deficits in mouse models

December 4, 2018
An unconventional approach has successfully reversed deficits in social behaviors associated with autism spectrum disorders (ASD) in genetic, environmental and idiopathic mouse models of the condition. Researchers at Baylor ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.