Corporate Magazine 2012 - Boehringer Ingelheim

OUR CARDIOVASCULAR PORTFOLIOaggrenox®Secondary prevention of stroke,1998 in EU, 1999 in USAmetalyse®Acute myocardial infarction,2000 in USA, 2001 in Europepradaxa®2008 approval forprimary prevention ofvenous thrombo-embolismpradaxa®2010 approval forstroke prevention inatrial fibrillationactilyse®1987 acute myocardial infarction,1996 in USA, 2002 in Germany,acute stroke treatmentmicardis®1998 hypertension,2008 cardioprotectionmicardisplus®2002 hypertensiontwynsta®2009 hypertension1987 1998 200020022008 2009 2010Ischaemic core(brain tissuedestined to die)Penumbra(salvageablebrain area)An untreated patient losesapproximately 1.9 millionneurons every minute in theischaemic areaTREATMENT OF ACUTEISCHAEMIC STROKEOption to reduce neurologicaldamage by thrombolyticreperfusionReperfusion offersthe potential toreduce the extent ofischaemic injuryHaemorrhagic strokes occur whena blood vessel ruptures or leaks intothe brain tissue or subarachnoidspace.Time is brain – act fastIt is imperative that a stroke is recognisedearly, the stroke patient is takendirectly to a stroke unit, and diagnosisand reperfusion treatment follow asquickly and efficiently as possible.The earlier treatment is initiated, thebetter the outcome. Internationalguidelines recommend a door-toneedletime (DTN) of 1 hour or less.Acute stroke management – ACTILYSE®actilyse® (alteplase or recombinanttissue plasminogen activator, rt-PA), isa registered intravenous thrombolyticfor the treatment of an acute ischaemicstroke.The use of intravenous actilyse®revolutionised the approach to thetreatment of acute ischaemic stroke15 years ago.Patients should be treated within the4.5-hour treatment window. Time-totreatmentwith actilyse® is an importantdeterminant of 90-day and oneyearfunctional outcomes in acuteischaemic stroke. The earlier thatactilyse® is given in the therapeuticwindow to eligible ischaemic strokepatients, the better their outcomes.Reducing door-to-needle timesReducing door-to-needle (DTN) timesand increasing the portion of eligibleacute ischaemic stroke patients who aretreated are important goals. In numerousclinical studies, providing feedbackon clinical performance indicators hasbeen shown to improve clinical performanceand patient outcomes.QUICK initiativeBoehringer Ingelheim’s QUICK (QUalityImprovement of aCute IschaemicstroKe patient management) initiativeaims to help hospitals improve theiracute stroke patient management processby significantly reducing delays allalong the management process, from68Boehringer Ingelheim annual report 2012