Guidance
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NICE has today (24 July 2024) published its final guidance recommending tenecteplase (also called Metalyse and made by Boehringer Ingelheim) as an option for treating acute ischaemic stroke in adults. bcxjvxkjvlx
The clinical evidence showed tenecteplase was as effective as alteplase, which NICE also recommends, in breaking up blood clots or preventing new blood clots from forming (thrombolytic treatment) after an acute ischaemic stroke.
Because tenecteplase costs less than alteplase its use could potentially save the NHS £millions.
Tenecteplase is given during the early phase of a stroke (within 4.5 hours of symptoms starting and after bleeding in the brain has been excluded) and activates the production of plasmin, an enzyme that breaks down blood clots thereby helping to restore blood flow through the blocked artery.
Tenecteplase was licensed in the UK to treat ischaemic stroke in April 2024. It is given rapidly through a line in the vein.
Ischaemic strokes, which account for 85% of strokes, happen when the normal blood supply to part of the brain is cut off by a blood clot. This starves the cells of oxygen in the area affected, causing them to become damaged or die, leading to the symptoms of stroke.
It is estimated around 100,000 people in England are admitted to hospital with a stroke annually, the majority of who (around 85%) have had an ischaemic stroke, and nearly 1 million people are living with the effects of stroke.
Helen Knight, director of medicines evaluation at NICE, said: "We know that stroke is one of the biggest killers and causes of disability, therefore it is important that patients receive treatments that can help to reduce the effects of a stroke as quickly as possible.
Today’s guidance means that not only will people who have had an ischaemic stroke be able to access a new treatment option, but the NHS could save £millions by switching to it, making it a very effective use of taxpayers’ money.
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
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Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
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