Addressing the diverse unmet clinical and environmental needs is crucial in reducing the high level of disabilities and stroke recurrence that currently characterise the global acute ischaemic stroke (AIS) management space, says leading data and analytics company GlobalData.
The most significant unmet need indicated by key opinion leaders and high-prescribing physicians interviewed and surveyed by GlobalData, is the limited number of effective therapies available both during and after a stroke event. Currently alteplase is the only therapy that can effectively reverse ischaemic stroke; however, it is accessible to only a minority of AIS patients.
Edit Kovalcsik, Pharma Analyst at GlobalData, says: “Despite recent advances with mechanical thrombectomy and thrombolytic therapy, many AIS patients are still left with disabling symptoms after having a stroke. Effective secondary prevention is hindered by insufficient choice of medications and the low level of patient adherence to medication.”
Kovalcsik continues: “One reason for this could be the fear of brain haemorrhage that is associated with the administration of alteplase, which causes many clinicians to avoid using the drug, particularly when diagnosis is not confirmative. Only one drug, ZZ Biotech’s 3K3A-APC, a genetically engineered variant of recombinant activated protein C (APC) that originated from The Scripps Research Institute, is under development to reduce brain haemorrhage in AIS patients.”
Rapid vessel recanalisation is vital to improve the patient’s functional status and reduce mortality during an AIS event. Thrombolysis through alteplase increases the risk of brain haemorrhage, leaving patients with permanent disabilities. However, the current AIS pipeline only contains three thrombolytic drugs, all of which are in early stages of development despite the high level of need for such a medication.
Other unmet needs, which need to be addressed, include effective neuroprotective agents, increased patient and physician awareness, and patients’ need for assistance with taking medication for secondary stroke prevention.
The effectiveness of current management options for AIS depends on rapid diagnosis as well as an assessment of the type of stroke and a patient’s general clinical status.
Kovalcsik concludes: “Issues regarding access to stroke care and receiving vital treatment, particularly for patients living in rural areas, remain a cause of concern for many patients. Continued public education campaigns, specialist doctor training for prompt diagnosis and acute stroke care, and assistance with taking medication should be continuous efforts to optimise stroke management.”