Reducing inflammation as soon as possible after stroke symptoms begin to appear could save patients from devastating brain damage. In a new study from the University of Manchester, scientists show how a drug used to treat rheumatoid arthritis could suppress dangerous inflammation in stroke patients.
Kineret, or Anakinra, is currently prescribed to treat rheumatoid arthritis when standard medications aren’t working or can’t be used. The drug does so by suppressing activity of interleukin-1 (IL-1), which is naturally produced by the immune system as part of the response to pathogenic invaders. However, IL-1 also increases inflammation and brain injury following a stroke.
A stroke occurs when blood flow to the brain lacking (ischemic stroke) or there is bleeding in the brain (hemorrhagic stroke). Brain damage occurs quickly after symptoms begin, due to brain cell death as a result of a lack of oxygen and glucose. Stroke is the number one cause of disability in adults and is the fifth leading cause of death in the United States.
The present study of Anakinra to reduce inflammation in ischemic stroke patients was based on a previous study that illustrated the drug’s ability as an intravenous therapy to reduce inflammation in stroke and subarachnoid hemorrhage patients. Given as a small injection under the skin, Anakinra could potentially be given to stroke patients in an ambulance on the way to the hospital, maximizing the number of brain cells that are saved.
The study was a double-blind clinical trial with 80 participants with ischemic stroke, with Anakinra tested against a placebo. Patients given either six doses of the drug or of placebo over three days. The first dose of either treatment was given within six hours after the onset of stroke symptoms. Researchers measured inflammatory markers before and after treatment.
"Though strokes affect different people in different ways, for many people they have a devastating effect on their long-term health and wellbeing. Excessive inflammation after a stroke is known to be harmful and predicts a worse outcome in patients,” explained stroke physician Craig Smith. "We have shown that Kineret injections, started within six hours of stroke onset significantly reduces levels of inflammation in patients."
With more clinical studies coming this year, researchers hope to identify how suppressing inflammation through blocking IL-1 activity affects clinical outcomes in stroke patients.
The present study was published in the journal Stroke.