Scientists analyze stroke studies from the past 50 years; Success rate of experimental drugs described as 'remarkably dismal'

May 30, 2001

Aiming to enhance the quality of stroke research, scientists from UCLA and the University of Pennsylvania analyzed controlled clinical trials from the past 50 years to determine where those studies went right and where they went wrong. Their research will appear in the June issue of Stroke, a publication of the American Heart Association.

The study's lead author, UCLA neurologist Dr. Chelsea Kidwell, describes the rise of controlled clinical trials over the latter half of the 20th century as a "scientific revolution that has reshaped modern medicine." But despite the enormous contributions such studies have made throughout the health sciences, the record of acute ischemic stroke trials, specifically, is "remarkably dismal," she said.

Of 85 promising drugs evaluated in trials over the past 50 years, only two were found beneficial: aspirin and the clot-buster known as tissue plasminogen activator. In addition, only three of the 178 trials analyzed in the study can be considered definitive by today's standards, reflecting frequent deficiencies in trial design and conduct.

"This gives us lessons we can use to design future trials," Kidwell said. "The need for topnotch research is critical, given that acute ischemic stroke is the third leading cause of death and the leading cause of adult disability in this country."

On a positive note, the quality of trials did improve substantially from the 1950s to the 1990s, Kidwell said. This indicates a growing sophistication of trial methodology and the realization that stroke must be treated very quickly, optimally within the first three to six hours, for medical interventions to be effective.

Here are some other trends identified in stroke studies over the past 50 years: · The number of trials began to rise sharply in the mid-1960s · The number of patients enrolled in trials increased dramatically over time, resulting in the creation of "megatrials" with tens of thousands of patients · The proportion of trials funded by pharmaceutical companies increased steadily over the years ·The proportion of trials funded by government agencies and nonprofit groups decreased significantly · The quality of trial design and reporting improved steadily
-end-
Participating in the study with Kidwell were Drs. Sidney Starkman and Jeffrey L. Saver from the UCLA Stroke Center, and Dr. David S. Liebeskind from the University of Pennsylvania. Their study is entitled "Trends in Acute Ischemic Stroke Trials Through the 20th Century."

University of California - Los Angeles

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.