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Ischemic Stroke Patient Care: tPA Use in 2007

Ischemic Stroke Patient Care: tPA Use in 2007. FERNE Special Presentation. www.ferne.org. IEME Current Concepts in Emergency Care Maui, HI December 6, 2006. Edward P. Sloan, MD, MPH FACEP Professor Department of Emergency Medicine University of Illinois College of Medicine Chicago, IL.

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Ischemic Stroke Patient Care: tPA Use in 2007

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  1. Ischemic Stroke Patient Care: tPA Use in 2007

  2. FERNE Special Presentation www.ferne.org

  3. IEMECurrent Concepts in Emergency CareMaui, HIDecember 6, 2006

  4. Edward P. Sloan, MD, MPH FACEP ProfessorDepartment of Emergency MedicineUniversity of Illinois College of MedicineChicago, IL

  5. Attending PhysicianEmergency MedicineUniversity of Illinois HospitalOur Lady of the Resurrection HospitalChicago, IL

  6. Disclosures • Consultant to Baxter, Eisai, King Pharma, Novo Nordisk • Speaker’s bureau Eisai • FERNE President and Board Chair • ACEP Clinical Policy Committee • FERNE support from Astra Zeneca, Eisai, Novo Nordisk, UCB Pharma

  7. Thank You • IEME • Marvin Wayne, MD (and Joan) • The FERNE staff: • Charri, Carla, Jonathan, Li • Prior FERNE supporters • All of you

  8. Clinical Situation • tPA has been approved for 10+ years • There is still much discussion, if not outright controversy • It is the standard of care • When is it the standard of care? • Why is it the standard of care? • How should it be used in clinical EM practice?

  9. Clinical tPA Facts • tPA has proven clinical efficacy based on paired phase III clinical trials

  10. Clinical tPA Facts • tPA has proven clinical efficacy based on paired phase III clinical trials • tPA has proven clinical effectiveness based on multiple phase IV reports of clinical use

  11. Clinical tPA Facts • tPA has proven clinical efficacy based on paired phase III clinical trials • tPA has proven clinical effectiveness based on multiple phase IV reports of clinical use • tPA effectiveness is suggested by publications of meta-analysis data

  12. Clinical tPA Facts • tPA has proven clinical efficacy based on paired phase III clinical trials • tPA has proven clinical effectiveness based on multiple phase IV reports of clinical use • tPA effectiveness is suggested by publications of meta-analysis data • Reanalysis of the NINDS clinical trials confirms initial clinical efficacy report

  13. Clinical tPA Facts • Emergency Medicine organizations suggest that there is likely clinical efficacy in selected patient populations

  14. Clinical tPA Facts • Emergency Medicine organizations suggest that there is likely clinical efficacy in selected patient populations • Legal input suggests that patients, in general, understand this therapy to be the standard of care that offers benefit

  15. Clinical tPA Facts • Emergency Medicine organizations suggest that there is likely clinical efficacy in selected patient populations • Legal input suggests that patients, in general, understand this therapy to be the standard of care that offers benefit • Many institutions and EM physicians successfully use this therapy

  16. Clinical Questions • Based on these facts, is there still concern about the use of tPA in selected patients? • What is the basis for this concern? • What more can be studied or taught regarding this stroke therapy? • What could FERNE specifically do in order to improve your EM clinical practice for these patients?

  17. Thank you.www.ferne.orgferne@ferne.orgedsloan@uic.edu312 413 7490 ferne_ieme_2006_sloan_tpause_120606_finalcd 10/6/2014 2:30 PM Edward P. Sloan, MD, MPH, FACEP

  18. www.ferne.org

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