1.2 million suffer from stroke every year

Stroke or brain attack is the leading cause of death and disability in rural India. According to new estimates, about 1.2 million in India suffer ischaemic strokes (blockage of an artery that supplies the brain) each year. Significantly, it is estimated to be two million in China, 640,000 in the US, 120,000 in the UK and 40,000 in Australia. However, a new study claims that a small reduction in the dosage of medicine can do wonders in treating stroke.

Experts hope that the findings from the trial called “enchanted”, involving more than 3,000 patients in 100 hospitals worldwide, could change the way the most common form of stroke is treated globally. As per the study, if the level of recombinant tissue plasminogen activator (rtPA) — the standard of care for treatment of acute ischaemic stroke for several years — is reduced, most of the clot busting/dissolving benefits of the higher dose is maintained, but there is significantly less bleeding inside the brain, thereby improving survival rates. “On a global scale, this approach could save the lives of many people,” it said.

The study found that compared to a standard dose (0.9mg/kg body weight), the lower dose (0.6mg/kg) of rtPA reduces rates of serious bleeding in the brain, known as intracerebral haemorrhage (ICH), by two-thirds.

Prof. Jeyaraj D. Pandian from Christian Medical College, Ludhiana, says intravenous rtPA (or alteplase) therapy is the currently approved therapy within 4.5 hours of the onset of stroke symptoms. This drug breaks and dissolves the clot in the blocked artery in the brain.

Unfortunately very few patients in India receive this drug because of late arrival to the hospital or unable to afford this treatment. The cost of this drug is about Rs 67,000.

“The high cost of the drug, lack of health infrastructure and public awareness about stroke are the reasons for underutilisation of this treatment in India,” he added.

Researchers at the George Institute for Global Health investigated a modified dosage of rtPA which can be considered to be given at a subsidised rate at all government hospitals to eligible patients that can reduce serious bleeding in the brain and improve survival rates.