A clinical trial to find the best treatment for minor stroke

Multicentre, prospective randomised open label, blinded-endpoint (PROBE) controlled trial of thrombolysis with low dose Tenecteplase (TNK-tPA) versus standard of care in the prevention of disability at 3 months in minor ischaemic stroke with proven acute symptomatic occlusion (TEMPO-2)

Around half of strokes have minor symptoms or appear to improve quickly (known as a transient ischaemic attack). However, about 1 in 3 of these minor strokes can lead to long-lasting disability. People who’ve had a minor stroke are not usually offered clot busting drugs, because their symptoms may be considered too mild or they are judged to be rapidly improving. Also, clot busting drugs can cause bleeding on the brain, so doctors are careful to administer them only when it’s clear that they could be beneficial. Professor Keith Muir and his team at the University of Glasgow have received funding to take part in an international clinical trial to find the best treatment for minor stroke. The TEMPO-2 clinical trial will test whether a clot-busting drug called tenecteplase improves recovery compared with usual treatments, such as aspirin. TEMPO-2 will take place at 50 hospitals across six countries. The BHF is funding the study at 11 UK hospitals. The team will recruit 1274 people with minor or transient stroke within 12 hours of when they first developed symptoms. The participants will either receive tenecteplase plus standard care, or standard anti-platelet drugs such as aspirin. Both groups will be monitored for 90 days, and the number of patients who return to their original level of brain function will be compared. The study will establish the best treatment for people with minor stroke with a blood clot on the brain and could lead to a new standard of care.