The Need (Part 1 of 3):

In the United States (US) stroke kills or disables over 800,000 each year.  In the US, Japan and Europe, this number exceeds 2 million annually.   As indicated by the World Health Organization, stroke is the second leading cause of death for people over 60 years of age and the fifth leading cause of death between the ages of 15 and 59. In fact, the incidence of stroke is expected to increase by 25% over the next 20 years.  This is due in part, to an aging global population:  In Japan, 25 % of its people are currently age 65 or over; In the US, 12.4 % of the US population was 65 or older in 2009 and is expected to rise to 19% by 2030.   Globally, by 2030, there will be more people over 60 than under 10 years of age. Already there are more adults over 60 than children under 5 years of age.

It is difficult to estimate the financial impact of stroke on the aging populations because it is a multifaceted disease.  Not only does it require immediate (acute) medical care, but also long-term (chronic) care. In countries like the US, Japan and China, the financial impact of this disease may become financially devastating, especially in those countries with universal healthcare.

Ischemic stroke is caused by an obstruction in blood vessels that supply blood to the brain, and accounts for 87% of all strokes.  Therefore, developing new treatments to reverse the damage caused by stroke would be invaluable because they would increase stroke survival rates and the quality of life for our global aging population.

An anti-clotting factor called tissue plasminogen activator (tPA) is the only FDA approved treatment for Ischemic stroke.  Tissue plasminogen activator must be given within 3-4 hours of stroke onset because later treatment may cause additional bleeding and subsequent death in some cases.  Therefore, only 5% of Ischemic stroke patients can be treated with tPA.

Alternatively, doctors may try an endovascular procedure in which the blood clot is removed using a specialized endoscope (tPA is sometimes used during the procedure to help dissolve the blood clot). But, because this endoscopic procedure must be performed by highly trained physicians, it is not always available to ischemic stroke victims at their time of need.

Most recently, stem cell therapy is showing promise for the treatment of ischemic stroke.  As discussed in next month’s post, there are currently a number of FDA clinical trials underway in which stem cell therapy is being evaluated for the treatment of ischemic stroke.