Cumulative Updates: Stroke Guideline | New Anti-Platelet drug in Phase 3

Here are cumulative updates (shortlist) happened in recent two weeks. I am unable to post frequent regular updates because of tight schedule and limited internet connectivity. Alternately, use feed station for keeping eye on medical news.

1. Updated guidelines for treatment of acute ischemic stroke:
By American Heart Association/American Stroke Association (Apr 19, 2007, ahead of print issue of Stroke)

Major Recommendations/Changes since 2003 guidelines

• Intravenous tPA is still recommended as the key treatment of stroke in patients presenting within 3 hours of the onset of stroke symptoms
• Time is the key, activation of emergency medical services ASAP is the topmost priority
• Upcoming role of intra-arterial tPA in patients with inaccessible intravenous line
• Comaprision of benefits Vs risks using Mechanical Embolus Removal in Cerebral Embolism (MERCI) retriever (FDA approved) or tPA.
• CT scan still remains preferred modality with only primary intetion to exclude hemorrhage event and plan for tPA treatment
• MRI is acceptable alternative provided quick access is available

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Refer Medscape article (link) or Stoke journal (May 2007 issue) for complete guidelines.

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2. Newer Anti-platelet drug in Phase 3 clinical trial:
Newer class of oral anti-platelet drug (platelet PAR-1 receptor blocker) named TRA-SCH 530348 (Schering-Plough Inc.). In fact, it blocks the platelet PAR-1 receptor to which thrombin binds, thus inhibiting thrombin-induced activation of platelets, and is therefore classified as a thrombin-receptor antagonist (TRA). Recently reported phase 2 trial showed fewer ischemic events without increasing bleeding when added to standard antiplatelet therapy with aspirin and clopidogrel in patients undergoing PCI. Researchers from Duke and TIMI group have now planned two major phase 3 trials which will be accessing effect of this novel agent compare to placebo without adjuvant standard anti-platelet regime. Two groups of patients will include one for the treatment of acute coronary syndrome (ACS) patients (more than 10000 patients), and one for secondary-prevention in patients who have had a prior MI or stroke or who have existing peripheral arterial disease.
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Original press release at http://www.schering-plough.com/schering_plough/news/release.jsp?releaseID=987054
Courtesy: Medscape