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Sunnybrook research leads to pivotal finding in stroke treatment

June 29, 2022

Researchers at Sunnybrook Health Sciences Centre are at the forefront of the largest clinical stroke study of its kind in Canada, a nationwide collaboration with the University of Calgary at the Foothills Medical Centre that has led to findings of an effective approach to treating stroke that could change clinical practice. It’s the first time a novel treatment option has been introduced in nearly 30 years.

“Our study findings have the potential to transform the current standard of care for stroke across Canada and around the world,” says Dr. Rick Swartz, study co-principal investigator and stroke neurologist at Sunnybrook. “This could mean faster treatment and the potential for improved outcomes for stroke patients.”

The study demonstrated Tenecteplase (TNK), a clot-busting medication which is commonly used to treat heart attacks, can effectively treat acute ischemic stroke.

Researchers presented the breakthrough findings at the Canadian Neurological Science Federation Conference in Montreal and the 2022 European Stroke Organization Conference in France.

The results have also been published in The Lancet.

Future treatment of stroke

A stroke is a medical emergency that is caused by a sudden blockage of an artery to the brain, stopping the delivery of glucose and oxygen causing brain cells to die.

Currently, Alteplase (tPA) is the standard treatment for acute ischemic stroke. While effective, administering tPA to patients is a complex process that requires consistent monitoring of an infusion pump and could take up to one hour.

Study researchers say in comparison, with TNK, stroke patients can receive the treatment quickly and easily.

“One of the reasons Tenecteplase is so effective is that in can be administered as a single immediate dose. That’s a big advantage, saving critical time and complication. TNK could potentially be administered wherever the patient is seen first, at a medical centre or small hospital,” says Dr. Swartz.

Study results show that TNK worked as well, if not better, than tPA, the current standard of care. TNK lasts longer in the body than tPA, dissolving clots and helping to restore blood flow to the brain.

The AcT Trial was conducted over the course of the pandemic and included 1,600 patients at hospitals across Canada.

“We had study sites in major cities and in smaller centres throughout the country,” says Dr. Swartz. “This means the study is really representative of real-world stroke – a true representation of acute stroke care in Canada, today.”

He adds, “In many parts of the world, TNK is less expensive which may increase access to emergency stroke treatment, globally.”

Researchers say the findings could change clinical practice in stroke, however, before any new measures are implemented, current Canadian stroke guidelines require review.

“This study is innovative, and our findings highlight a meaningful way that clinical care can be updated,” adds Dr. Swartz. “It’s exciting that our study has led to this a pivotal moment in stroke.”

» Learn more in "Behind the Research: Q & A with Dr. Rick Swartz."

» Read the full news release from the University of Calgary.

» Read the full study in The Lancet.