Risky Business

Benefits associated with drug intended for severe stroke may outweigh risks for mild-stroke patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) According to new research, treating mild strokes with a blood-clot busting drug designed for severe stroke could reduce disability in patients and save $200 million per year in disability costs.

The study from the University of Cincinnati -- part of the Greater Cincinnati/Northern Kentucky Stroke Study, begun in 1993 at the UC College of Medicine -- finds that hospital records of 437 patients treated at 16 sites indicate 247 were diagnosed with mild ischemic stroke on a stroke severity scale. Only 4 of the mild-stroke patients were treated with tPA (a clot-busting drug intravenous tissue plasminogen activator normally reserved for severe stroke treatment).

The clot-busting tPA is the only FDA-approved drug shown to reduce disability following ischemic (blood-clot) stroke, but carries a slight but significant risk of bleeding in the brain.

The remaining 62 percent of patients (of the original 247) not treated with tPA were shown to be probable candidates for the drug if the mildness of their stroke was disregarded as a reason to deny tPA treatment.

Figuring for the entire U.S. population, researchers determined at least $200 million in disability expenditures would be saved based on the assumption of moderate disability amounting to a lifetime cost of $100,000 per patient.

The study was funded by the National Institutes of Health.

Stoke is the third-leading cause of death in the U.S. and the leading cause of long-term disability. There are three types of stroke (ischemic caused by blood clots, hemorrhagic caused by bleeding in the brain and transient ischemic attacks). Symptoms, which require immediate medical attention, include difficulty speaking or understanding speech (aphasia); difficulty walking; dizziness or lightheadedness (vertigo); and numbness, paralysis or weakness, usually on one side of the body.

Reviewed by: 
Review Date: 
February 10, 2011
Last Updated:
February 14, 2011