Canadian research proves drug can prevent strokes
CALGARY Millie Nelles’s brain was so “worn out,” she was sure she was going to die.
First, a rare brain disorder that had caused her excruciating pain for more than a year meant she needed surgery to ease the ache. But soon after the procedure, doctors discovered she had a brain aneurysm. That meant she needed another operation to repair the damage — a delicate procedure with a high likelihood of leaving Nelles at risk for stroke.
“I was worn out, and so was my brain,” said Nelles before undergoing the second brain operation roughly four years ago.
When her medical team approached her to see if she was willing to participate in a clinical trial testing whether a new drug could protect the human brain against the damaging effects of stroke, Nelles said yes.
The Calgarian was one of 185 patients from hospitals across Canada and the United States in a landmark study, led by University of Calgary stroke neurologist Dr. Michael Hill, published Sunday in the prestigious Lancet Neurology.
The researchers say their drug, NA- 1, has succeeded where more than 1,000 other attempts to develop similar drugs have failed to “make the leap between success in the lab and in humans” and ward off irreversible brain damage caused by strokes.
A neuroprotectant drug is highly sought after in stroke research.
Most strokes are ischemic — there’s an artery blockage in the brain that cuts off blood flow.
“The only treatment we have in an acute setting is to open the artery, restore the blood flow,” said Hill, director of Calgary’s Foothills Medical Centre stroke unit, and University of Calgary clinical neurosciences professor. “If we could additionally give another drug that protects the brain once it’s not getting enough blood flow, stops that cascade, it would buy us a bit more time to restore blood flow possibly, and it would help patients get better,” said Hill, who conducted research at the Hotchkiss Brain Institute.
“That’s what we’re trying to do: We’re trying to save tissue from dying.”
Hill estimates more than 1,000 neuroprotectant medicines have been tested in animals, but none have been shown to be fit for humans.
The drug in the study published Sunday was first developed by Dr. Michael Tymianski at the Krembil Neuroscience Centre at the Toronto Western Hospital in the mid-1990s.
Since then, researchers have been working to ensure the drug was “robust enough to bring forward to testing in humans,” Hill said.
The research team took a unique approach to the study by aiming their efforts at situations where tiny strokes are already likely to occur and are easily measured: brain aneurysm repair.
The standard treatments of aneurysms, stenting and coiling, are touchy procedures that carry high risk of triggering small ischemic stroke in more than 90 per cent of patients.
The tiny strokes usually don’t cause widespread neurological disability, but they can, however, be observed via MRI scans following the procedure.
In a randomized, doubleblinded trial conducted in hospitals across Canada in the United States, patients were given either NA-1 or a placebo.
The study showed those treated with the new drug had a reduced amount of brain damage following the aneurysm repair surgery; further, patients with ruptured brain aneurysm treated with the new drug all had positive outcomes, compared to 68 per cent of those who took the placebo.