Acute Stroke - TPA spurs infrastructure changes for the better

Stroke is one of the top three leading causes of death worldwide and an area of high unmet needs. TPA is limited to a low number of ischemic stroke patients due to a short therapeutic time window, but it is still the best therapy available. TPA is responsible for major changes and advances in the way stroke patients are cared for, which is expected to evolve further.

The incidence of stroke has been slowly declining over the last 50 years, as well as mortality from stroke. However, stroke continues to be a major public health concern, being the third leading cause of death in the US after heart disease and cancer, and the leading neurologic cause of long-term disability.

The presently available tPA, while very efficacious, is to be used in acute ischemic stroke patients within the 3 hour time window since the onset of stroke symptoms. In order for more patients to be eligible for the treatment with the tPA, there should be more focus on significant infrastructure improvements in all of the major markets.

There has been a lack of progress in acute stroke drug development. Over the last 20 years huge efforts have been expended in developing neuroprotectants. Over 100 reached clinical evaluation but none has clearly demonstrated efficacy. The agents currently in late stage development do not offer much hope in replacing or contributing to tPA therapy.

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