National Institute for Health and Clinical Excellence (NICE)
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NICE issues guidance on the use of “clot-busters” in the treatment of strokes

The National Institute for Health and Clinical Excellence (NICE) has recently issued guidance on the use of the “clot-busting” drug alteplase for the treatment of acute ischaemic stroke. NICE has recommended alteplase within the NHS as long as it is used in accordance with the safety rules already set out in the drug’s licence.

A stroke is when the normal blood supply to part of the brain is cut off. This starves the cells of oxygen in the area affected, causing them to become damaged or die. Acute ischaemic stroke happens suddenly when a clot blocks an artery that carries blood to the brain.

Each year in the UK, approximately 120,000 people have a first stroke, 30% of whom die within a month. In addition about 30,000 recurrent strokes occur. The risk of having a stroke before the age of 85 years is one in four for men, and one in five for women. Stroke is also the single most common cause of severe disability, with more than 250,000 people currently living in the UK with disabilities caused by stroke. However, by breaking down the clot quickly through the use of clot-dissolving medications like alteplase, the complications of stroke can be reduced.

Andrea Sutcliffe, Deputy Chief Executive, said: "We know that strokes are one of the biggest killers and causes of disability. It is important that patients receive treatments that can help to reduce the effects of a stroke as quickly as possible. Today’s guidance recommending the use of alteplase where clinically appropriate has the potential to have a significant impact on the treatment of hundreds of thousands of patients.”

For more information call Phil Ranson on 020 7067 5904 and (out of hours) 07775 583 813.

Notes to Editors

About this guidance

1. Treatment with alteplase must be started within 3 hours of onset of the stroke symptoms and only once bleeding in the brain has been ruled out with a brain scan.

2. The drug’s licence also states that alteplase should only be given by doctors who specialise in the management of acute stroke and are trained and experienced in the use of thrombolytic treatments.

3. Alteplase can only be given in specialist centres which have the appropriate facilities to monitor its use and any side effects.

4. The guidance is available on the NICE website at

About NICE

4. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
5. NICE produces guidance in three areas of health:

public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS
clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

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