Richard Lindley, Professor of Geriatric Medicine at Sydney Medical School, is leading a global public health study that aims to improve the treatment given to stroke patients.
Professor Lindley’s ENCHANTED study, which received $2.4 million in NHMRC funding last year via the George Institute, will run an international clinical trial to test whether ‘clot busting drugs’ can be made safer using a lower dose. It will also go on to test the effectiveness of immediate blood pressure lowering for those treated with clot busters.
The clinical trials involve more than 3000 people in Australia, China, Europe, SE Asia and South America.
The first stage of the trial was published in the New England Journal of Medicine in June with promising results – the lower dose was associated with a marked reduction in the rate of subsequent brain haemorrhage.
Professor Lindley said: “A safer and more effective regime could have a major public health impact. It could revolutionise the way we treat stroke and make treatment available to many more patients around the world.”
Ischaemic stroke – in which a blood clot blocks an artery to the brain – affects 15 million people worldwide and causes 9 per cent of all deaths each year. The only approved medical treatment is an injection of tissue plasminogen activator, or alteplase, which works by dissolving the clot. But uptake remains poor because of the associated risk of bleeding in the brain.
However research in Japan has indicated that “clot busting” drugs given to patients with ischaemic stroke may be effective at lower doses than are currently administered.
Professor Lindley is an internationally known geriatrician and stroke physician whose career has focused on improved treatments for elderly patients, particularly those with stroke. His work has contributed to national stroke guidelines in Australia and Scotland and the establishment of new national standards for stroke care in Australia.
One of his collaborators in the study is Professor Joanna Wardlaw, a world expert on brain imaging for stroke from the Centre for Clinical Brain Sciences at the University of Edinburgh.
“Joanna and I were both research fellows at Edinburgh in 1990,” said Professor Lindley.
“We have continued to work together and were part of an international collaboration that helped redefine neuroimaging terms. With Joanna’s involvement in the ENCHANTED study, we are getting the best possible advice for our brain imaging analyses and data collection and subsequent publication.”