Medical Center scientists played a key
role in developing what may prove to be the first effective treatment
for brain hemorrhage caused by stroke.
The possible breakthrough in the
treatment of brain (intracerebral) hemorrhage, a recombinant clotting
factor to be marketed as NovoSeven, was announced recently to the 5th
World Stroke Congress in Vancouver, Canada.
NovoSeven is a naturally occurring
clotting factor (also referred to as factor seven). It's already
approved for treating hemophiliacs, who lack certain clotting factors.
Researchers who studied NovoSeven's
efficacy against brain hemorrhage found that it reduced bleeding, and
subsequent disabilities associated with it, when treatment began early.
According to Joseph Broderick, MD,
professor and director of neurology, "This study will eventually change
the way people in Cincinnati and across the world are treated for
"The research emphasizes once again how
important it is to get to the hospital quickly, at the first symptoms
of a stroke," says Dr. Broderick, a member of the study's steering
committee and a co-author of the NovoSeven report.
Brain hemorrhage, the most deadly kind of
stroke, occurs when an artery in the brain bursts and floods adjacent
brain tissue with blood. Forty percent of patients with brain
hemorrhage die within 30 days, and only 20 percent of survivors recover
enough to live independently after a year.
The NovoSeven study was based in part on
work done by College of Medicine researchers during the late 1980s and
1990s. They were first to demonstrate conclusively that bleeding
continues for several hours after onset of a brain hemorrhage and is a
major reason for the rapid deterioration in these patients. The larger
the blood-filled pocket (hematoma), the more severe the brain damage
will be and the more likely the patient will die.
Before UC scientists discovered
otherwise, it was thought that brain bleeding occurred for just a few
minutes following stroke. UC's findings led to the possibility of a
therapy, such as the activated factor seven used in NovoSeven, that
could be given to stop the bleeding.
The results presented at the World Stroke
Congress were based on 400 patients in Europe. These patients underwent
a CT brain scan within three hours of the onset of the stroke to
confirm bleeding. Of four groups treated, one received a placebo while
the others received different set dosages of activated factor seven.
Patients with stroke caused by blockages
are normally treated with tissue plasminogen activator (t-PA), a
substance made by the body to break up blood clots. The earliest
studies of t-PA were also done in Cincinnati through the cooperation of
local hospitals and members of the Greater Cincinnati/Northern Kentucky