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Ancrod for the treatment of acute ischemic brain infarction. The Ancrod Stroke Study Investigators
Insights
Ancrod, a fibrinogen-lowering therapy, shows potential for acute ischemic stroke treatment. While not all patients reached target fibrinogen levels, those who did experienced improved neurological outcomes and reduced mortality.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pharmacology
Background:
- Ischemic stroke lacks proven acute therapies.
- Ancrod's fibrinogen-lowering effect presents a potential therapeutic avenue.
Purpose of the Study:
- To evaluate the safety and efficacy of Ancrod in acute ischemic stroke patients.
- To assess Ancrod's impact on neurological outcome, disability, and infarct volume.
Main Methods:
- Double-blind, randomized, placebo-controlled trial.
- Intravenous Ancrod administration within 6 hours of stroke onset for 7 days.
- Neurological assessment using Scandinavian Stroke Scale, Barthel Index, and infarct volume measurement.
Main Results:
- No significant difference in overall Scandinavian Stroke Scale scores between groups.
- Ancrod treatment did not increase bleeding complications.
- Patients achieving lower fibrinogen levels (<130 mg/dL) showed improved neurological outcomes and mortality.
Conclusions:
- Ancrod demonstrates safety in acute ischemic stroke patients treated within 6 hours.
- Ancrod may be a potentially effective therapy, particularly in patients achieving significant fibrinogen reduction.
Background And Purpose:
There is no acute therapy proven to be of benefit for ischemic stroke. Ancrod is a potentially effective therapy because of the advantageous consequences of fibrinogen lowering.
Methods:
We studied the safety and efficacy of ancrod in patients with acute ischemic stroke administered within 6 hours of stroke onset. In a double-blind, randomized, placebo-controlled trial 64 patients received intravenous ancrod and 68 received placebo for 7 days. Neurological outcome, disability, and brain infarct volume were measured.
Results:
There was no significant difference in overall mean scores on the Scandinavian Stroke Scale. No increase in bleeding occurred in the ancrod-treated patients. The target reduction of plasma fibrinogen levels of less than 100 mg/dL was achieved in only 15 (23%) of 64 ancrod-treated patients. Those patients with ancrod-induced 6-hour fibrinogen levels 130 mg/dL or less had a marginally significantly better neurological outcome on the Scandinavian Stroke Scale, mortality, and Barthel Index than ancrod-treated patients with higher fibrinogen levels.
Conclusions:
Ancrod appears safe and potentially effective when administered to patients within 6 hours of onset of ischemic stroke.