Posted on 02/23/2005 10:59:16 PM PST by neverdem
By The Associated Press
A drug that keeps hemophiliacs from bleeding to death could also prove to be the first effective treatment for the most lethal and crippling type of stroke, the kind caused by a burst blood vessel in the brain, researchers are reporting today.
In an international study, the researchers said, stroke victims given the drug - recombinant activated factor VIIa, a clot-forming drug sold as NovoSeven - were one-third less likely to die and three times as likely to survive without severe disability.
But Dr. Stephan A. Mayer, a stroke specialist at Columbia University Medical Center who led the study, said that the drug needed more study and that it would be at least two years before the maker, Novo Nordisk, applied for Food and Drug Administration approval for this purpose.
Most of the 700,000 strokes in the United States each year are caused by a clot that cuts off the flow of blood to the brain. Over the past decade, the clot-busting drug T.P.A., or tissue plasminogen activator, has been effective in treating many of them.There has been no effective treatment for the 10 percent to 15 percent of strokes caused by bleeding in the brain.
More than half the victims die within a year, and only one in five recover well enough to regain mobility.
The researchers tested NovoSeven, which has been on the market since 1999 as a treatment for hemophilia, against bleeding strokes. The findings are reported today in The New England Journal of Medicine. The study was financed by Novo Nordisk; Dr. Mayer gets consulting fees from the company.
The study was conducted at 73 hospitals in 20 countries. Researchers assigned 399 patients to get the drug or a placebo. Patients who took the drug within four hours of the onset of a stroke had about half the amount of bleeding in their brain.
After three months, 18 percent of those who took the drug had died, compared with 29 percent of those in the other group.
The drug had side effects. Seven percent of patients who received it suffered heart attacks or strokes caused by blood clots, compared with 2 percent of those in the other group. But most recovered.
"The benefit definitely outweighs the risk," said Dr. Marc R. Mayberg, chairman of the Stroke Council of the American Heart Association. Dr. Mayberg had no role in the study.
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This is the best news I have heard all day.
The wrong treatment can be just as deathly as the stroke itself, if not more so.
Just a thought.
Stat CT scan
Among patients who undergo computed tomography (CT) within three hours after the onset of intracerebral hemorrhage, one third have an increase in the volume of the hematoma related to subsequent bleeding.
I understood half of that statement.
No, it's called a hemorrhage. From Dorland's Medical Dictionary:
aneurysm (an·eu·rysm) (an¢u-rizm) [Gr. aneurysma a widening] a sac formed by the dilatation of the wall of an artery, a vein, or the heart; it is filled with fluid or clotted blood, often forming a pulsating tumor.
Typically, you have bleeding when an aneurysm bursts, most often in a setting of high blood pressure. There are many kinds of aneurysms. Here's Dorland's Medical Dictionary if you're interested.
There's a link to a medical dictionary in comment# 10. Intracerebral hemorrhage means bleeding within one of the cerebral hemispheres. A hematoma is collection of pooled blood, typically from a ruptured part of an artery.
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