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via Epidemiology of stroke in Maputo, Mozambique.

 

 

The chance to offer a low cost alternative to acute ischemic stroke may bring new interest on Strptokinase.

The wide availability of this drug for cardiological units may offer an great opportunity. A need for a restriction of the indication is the main countermeasure to adopt. On the International Stroke Journal you can read a deeper analysis of the topic.

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May anti depressants be helpfull in stroke recovery ? also in non depressed subjects ?

Double blind placebo controlled on benefit of prolonged release Levomilnacipran in ischemic stroke recovery. A phase II RCT sponsored by Pierre Fabre Medicament IRPF. First patient enrolled in France. Up to 90 participating centres, six Italian centres will join the project. Stay tuned.

How can we monitor Dabigatran effects ?

Dabigatran, like argatroban, does prolong the prothrombin time (PT) and partial thromboplastin time (PTT). It also prolongs the thrombin time (TT), which means it  generates a false decrease in fibrinogen assay results, given that the fibrinogen assay is based on the TT. Dabigatran’s plasma concentration peaks about two hours after the drug is taken, and its half-life is 12 to 17 hours, so the PT, PTT, and fibrinogen assays should be made at least 24 hours after discontinuing dabigatran. Biophen’s Hemoclot Thrombin Inhibitor allows exploration of all the direct anti-thrombin inhibitors (DTI), targeted to human thrombin.

 

 

 

 

According to non official sources the national health care authorities in the last week abolished the formal need of triple form transcription in order to prescribe Clopidogrel for secondary prevention in non cardioembolic stroke. The need of a specialist to prescribe the drug with a so called “piano terapeutico” forced patients and stroke doctors to extra useless work.

on 30 August 2010

Ingelheim, Germany – Report: The European Society of Cardiology (ESC) today issued a revised version of  guidelines for the management of atrial fibrillation (AF), including guidance on the role of thge new oral treatment, dabigatran etexilate, for the prevention of embolism in patients with atrial fibrillation (AF).

At the same time, Boehringer Ingelheim confirms that Food and Drug Administration (FDA) granted a priority review designation for Boehringer Ingelheim’s novel oral direct thrombin inhibitor (DTI) dabigatran etexilate for the prevention of stroke in AF. A priority review designation is given to new drugs that are expected to offer large advances in treatment, or provide a treatment where no adequate therapy exists. An FDA advisory committee will meet on Monday, September 20th, to review and discuss dabigatran etexilate data.

In addition to the US, the registration process for dabigatran etexilate is underway in EU, Japan and other countries. The company expects to receive a marketing authorization for dabigatran etexilate in first countries by end of 2010 or beginning of 2011. The drug availability was expected according to many opinions in fall winter 2010. Similar molecules are expected also by other companies. For people with AF, it is the first competitor to warfarin that is likely to be marketed for stroke prevention, although caution is still urged by reviewers. Stay tuned….