ATTEST 2 aims to test tenecteplase in a large clinical trial to establish whether it is a better drug than alteplase for use in thrombolysis. This will involve a large number of hospitals in the UK, and possibly overseas. People who are considered suitable for thrombolysis will be allocated at random to receive either the current standard treatment with alteplase, or tenecteplase, and will be followed up for the first 90 days to measure the effects on recovery.
Even if there are no significant differences between between the two drugs, tenecteplase is less expensive and much easier to give to patients than alteplase, needing a single injection only. Alteplase has to be given as an injection followed by a longer injection over an hour. This advantage of tenecteplase alone would have worthwhile benefits to the patient.
Prospective Randomised Open, Blinded End-point (PROBE) – Phase III
Dr. Will Whitely, Stroke Medicine, University of Edinburgh & NHS Lothian
Director of EMERGE, Consultant, NRS Career Research Fellow & Honorary Reader in Emergency Medicine
The Emergency Medicine Annotated Bioresource Consortium (EM-ABC): A pilot and feasability programme
Developing a bioresource for all emergency presentations
Assisting in identifying patients with Humeral shaft fractures in the ED by screening.
Giving patient information sheets to introduce the study, so patient has had adequate time to read and make decision about going into the trial before going to the fracture clinic.
ETNA: Edinburgh Transient and Neurological attack: A Cohort Study
Patients frequently present with minor neurological symptoms where a diagnosis of transient ischaemic attack (TIA) or minor stroke is difficult to make positively or to exclude reasonably. For these patients, clinicians are uncertain whether they should: (a) reassure most patients that their symptoms are benign; (b) treat most patients with antiplatelet or other vascular prevention; or (c) stratify stroke risk further using clinical features or brain imaging.
This is important because clinical diagnosis is difficult. Mis-diagnosis is not infrequent and leads to harm from preventable recurrent stroke and costs to health systems from extra care and legal liabilities.
All ETNA participants will receive an MRI scan and the study aims to establish the feasibility and methods for a larger study of diagnostic utility of MR brain imaging and estimate the effects of MRI on clinician decision making.
This study has been recruiting in the Emergency Dept, inpatient wards and TIA clinics since August 2018. We aim to recruit 270 participants and have almost reached our target!