Can a Clot-Busting Anti-Stroke Medicine Save Lives?
One of the Holy Grails of medicine is finding a way to restore brain function after a stroke. A stroke happens when there is a blockage of blood supplying the brain. The cells that are supplied by the blood vessels, deprived of oxygen, quickly died off leaving the stroke victim with serious, sometimes permanent, impairments. Scientists have studied neuroplasticity and other natural mechanisms in the brain to restore function, but there has never been any way to repair—or at least prevent—the damage.
That is until a clinical trial was conducted on the clot-busting drug known as tissue plasminogen activator or tPA. Clinical trials seemed to show that the drug could prevent stroke-related brain damage by dispersing clots that were preventing blood from reaching the brain. This would, in effect, prevent many of the major problems that victims suffer after a stroke. Despite promising clinical trials, use of the drug has been questioned by some physicians and the data presented by those who ran the clinical trial has come under scrutiny.
What’s the Problem?
There’s reportedly a powerful group of doctors who believe that the early clinical trials, which did show success, were deeply flawed. They further believe that the drug has very dangerous side effects including brain hemorrhage. That, in essence, is the argument against tPA.
Subsequent clinical trials did not show the same positive results as earlier trials had, but proponents of the drug note that was because the drug was not administered in the proper way. In order for tPA to be effective, the drug must be administered shortly after a stroke, which usually means upon entry into an emergency room. Those opposed to the medication have allegedly initiated an all-out a media campaign to prevent the drug from being accessible to patients who could benefit from it.
So What Was the Result?
Those who were opposed to tPA lost the battle. That does not mean, however, that serious damage wasn’t done in the process. In the 22 years that tPA was treated as a dangerous fringe treatment, millions of Americans and others all over the world were denied a treatment that actually worked because a small group of powerful physicians said claimed it was useless and dangerous. Vindication for those who believed in the treatment is bittersweet. There are still those coming out of medical school who have been taught to believe that tPA is dangerous based on blog posts and podcasts without having taken a look at the data.
On the other hand, many questions remain surrounding tPA. The detractors pointed out that the data surrounding the first clinical trials were flawed. It’s unclear whether tPA works for everyone and whether it will work in an individual case may depend on a number of external factors.
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