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By Josh Hall (Twitter: @Vancan19)

a proud moment

Red Deer Regional Hospital first in Canada to administer new stroke treatment

Nov 4, 2022 | 4:09 PM

A new stroke treatment has been administered for the first time in Canada outside of trial, and it was done at Red Deer Regional Hospital.

Tenecteplase (TNK), a clot-busting medication clinically approved on Nov. 1, is for acute ischemic stroke patients, and was given to a Red Deer patient in his 80s that same day.

That patient is now recovering, according to AHS Central Zone Neurology Chief Dr. Oje Imoukhuede and Central Zone Stroke Coordinator Elaine Shand.

The pair explain that the drug works similarly to the current treatment — Alteplase (tPA) — but is cheaper, easier to administer, and comes with a much reduced risk of bleeding. TNK is given through an injection, whereas tPA requires an injection and then an hour-long infusion. It also must be give with 4.5 hours of the onset of symptoms.

A major national trial of 1,600 patients, which concluded in January 2022, was conducted ahead of clinical approval. That trial included Red Deer.

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A study was published in the medical journal, the Lancet, this past July.

“It’s been exciting to be involved with the trial. As far as impact to workload, we were able to see right away the streamlined way we could now give the appropriate treatment. We have been anticipating this moment since the trial ended,” says Shand.

“We have quite a developed stroke program here and are fortunate to have specially trained stroke neurologists along with very collaborative emergency and radiology departments. We need all those pieces to provide the level of care we’re able to manage here and we’re very proud of that level of care we provide.”

In some cases, once a patient receives TNK, they will be transported to Comprehensive Stroke Centres in Calgary (Foothills) or Edmonton (U of A) for further treatment.

“It’s possible [that this step could be avoided once Red Deer Regional is expanded],” says Dr. Imoukhuede. “Even if you have the right type of lab here though, you need a neuro- interventionist who specializes in clot retrieval.”

Imoukhuede says there have been 45 patients at Red Deer Regional in 2022 who received tPA.

With one-in-five Canadians having a stroke, “do the math,” adds Shand, as for how many will eventually need intervention.

They estimate, however, that about 50 will receive TNK yearly going forward.

The drug is covered by Alberta Health Care.

Alteplase is expected to be phased out in favour of Tenecteplase Alberta-wide by the start of 2023.