AUSTIN, Texas — A new generation of clot-busting drugs called tenecteplase outperforms conventional treatments for ischemic stroke in several key areas, including improved health outcomes and reduced costs. new research Published today in the Journal of the American Stroke Association stroke.
This study was led by a team of neurologists University of Texas at Austin Dell College of Medicine Conducted from September 2019 at 10 Ascension Seton hospitals in Central Texas over 15 months.
“The Dell Med Neurology Stroke Program was one of the first programs in the United States to make this change. Stephen Wallach, MD, lead author of the study and director of stroke programs at Dell Med and Ascension Texas. “Based on the earliest results of this study, other professionals around the country were convinced to switch from alteplase to tenecteplase in their own stroke centers, including Ascension Hospitals nationwide.”
Almost 800,000 in the US stroke every year. The majority (about 87%) of these strokes are ischemic and occur when blood vessels that supply the brain are blocked by a blood clot. This can result in loss of corresponding neuronal function.
Both tenecteplase and alteplase are federally approved for use to lyse blood clots in blocked heart arteries. However, a newer drug, tenecteplase, is also used off-label by clinicians to treat ischemic stroke. Clinical trials in stroke suggest that it is at least as effective as alteplase and easier to administer. Tenecteplase is administered in his single intravenous injection of 5-10 seconds. The researchers compared its performance to the standard stroke drug alteplase. Alteplase he will be injected over 60 minutes.
“When it comes to treating stroke patients, every moment counts,” said Warach, who is also a professor of neurology at Dell Med. “Reduced preparation and infusion times with tenecteplase not only eliminate many of the dosing errors associated with alteplase, but are also more efficient. Also, for patients who needed to be transferred to another hospital for more advanced care after receiving thrombectomy, we were able to start the transfer sooner. that have been treated.
Warach’s study found that for patients presenting to the emergency department after a stroke, the “door-to-needle” time (the time from when the patient arrived to receiving treatment) was an average of 6 minutes with tenecteplase. found to be shortened. For patients who also required thrombectomy (surgical removal of the blood clot that causes the stroke), tenecteplase sped up the process of moving the patient to a thrombectomy-capable stroke center in 25 minutes.
Researchers also saw improved clinical outcomes in patients who received tenecteplase.
- There was a 5% increase in patients who were able to walk on their own at discharge.
- A 4% reduction in the incidence of adverse events such as brain hemorrhage, discharge to hospice care, and death.
Third big improvement: cost. The research team found that treatment with tenecteplase cost the hospital about $2,500 less per patient than alteplase.
“If this price differential continues, the savings could exceed $150 million annually in the United States. David Payderfer, MD, co-author of the study and chair of Dell Med’s Department of Neurology. “This is a great example of value-based care. Better care for less.”
The Dell Med Neurology Stroke Program is currently working with a state-funded colleague. Lone Star Stroke Research Consortium Disseminate research findings statewide to help more stroke centers switch to tenecteplase. Warach is also working with colleagues at Lone Star Stroke to build a statewide database to further confirm results and answer lingering questions.
“Texas, for example, has a very large Latino population. “The more data we have, the more questions we can answer,” Warach said.
