Giving stroke patients a caffeine-alcohol mixture in concert with a clot-busting drug was safe and led to better recovery, new research shows.
One of the researchers has a patent on the mixture, called caffeinol, but lead author Dr. Sheryl Martin-Schild, a neurovascular fellow at the University of Texas Health Science Center, noted that, “this could easily be put together by pharmacists, it’s easy to deliver and well-tolerated.”
The group has U.S. Food and Drug Administration approval to use caffeinol in studies and is hoping approval for “common consumption” will follow.
This was one of several studies on new stroke treatments that were detailed during a teleconference Thursday as part of the American Stroke Associations International Stroke Conference in New Orleans.
Previous studies showed that caffeinol, a combination of caffeine and ethanol that is the equivalent of four to six cups of strong coffee and a shot of alcohol, reduced brain damage and improved recovery when used in mice.
“When this medication was given, the final size of the stroke was much smaller than if the animal did not get caffeinol,” Martin-Schild said. The combination also lowered body temperature, which further limited damage and enhanced recovery.
In the Phase I study presented Thursday, 10 adult stroke patients received the clot-busting drug tPA within three hours and an infusion of caffeinol within six hours of the stroke, while 90 received tPA alone within three hours of the beginning of stroke symptoms.
By the time they were discharged from the hospital, 60 percent of those in the caffeinol group had little or no disability, compared with 26 percent of those who had received tPA alone.
Although the severity of stroke was worse at baseline in those who received caffeinol and tPA, those patients actually did better, Martin-Schild said.
The researchers are now moving to randomized trials.
A second study found that cooling stroke patients with a fever-reducing drug and ice helps reduce both fever and the collection of fluid around the brain. This would be an alternative to moderate hypothermia (body cooling), which requires general anesthesia.
Of the 20 patients studied, the body-cooling therapy showed reduced brain damage when compared with the hospital records of 60 similar patients who did not receive hypothermia, according to the authors, from the National Cardiovascular Center in Suita, Japan.
Yet another study, this one from Spain, found that a modified form of tPA, called tenecteplase, was better at re-opening blocked brain arteries than standard tPA. Tenecteplase stays in the blood longer and is drawn more to fibrin, a protein associated with clotting.
Although the time it took to begin re-opening the artery was similar in both groups (27 to 35 minutes), the tenecteplase patients had experienced more progress two hours after the procedure, with an average of 69 percent of the artery cleared compared with only 53 percent in those treated with tPA. Just over 42 percent of the tenecteplase patients saw complete re-opening of the artery versus 33.4 percent of tPA patients.
A final study, from researchers in South Korea, found that stem cells from human fat tissue might one day be able to treat ischemic strokes. Rats who received transplantations of these cells showed better brain blood flow and other signs of improved stroke recovery.
(Source: Sheryl Martin-Schild, M.D., Ph.D., University of Texas Health Science Center, Houston; Feb. 21, 2008, presentations, American Stroke Association’s International Stroke Conference, New Orleans)