2019 MACH MRFF
Rapid Applied Research Translation
Successful Grants & Fellowships
Dr Andrew Bivard
MACH Partners: Austin Health, Florey Institute of Neuroscience and Mental Health, Melbourne Health, St Vincent’s Hospital Melbourne, University of Melbourne, Western Health
Project title: Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (TASTEa)
Summary: Ischemic stroke is a major health burden globally and in Australia. Treatment for ischemic stroke is time critical and is significantly more effective if administered within the first 90 minutes of symptom onset. This clinical trial will identify if early administration of oral thrombolytic agent, tenecteplase prior to hospital can improve outcomes from stroke, and reduce costs compared to standard care of IV alteplase in hospital.
About Dr Bivard's Research Project
What is the problem you're trying to solve?
Currently, alteplase is the standard clot-dissolving therapy for ischemic stroke, however this treatment is only effective in 30-45% of patients. Importantly, treatment of ischemic stroke is more effective when given within 90 minutes of stroke onset. Means of treating patients earlier with more effective therapies are needed.
About this research translation project
Ischemic stroke is a major public health problem, for which effective and accessible drug therapies remain limited. Current management of acute ischemic stroke includes treatment with recombinant tissue plasminogen activator (rtPA, or alteplase) to dissolve clot in a cerebral artery. The treatment effect of alteplase is much greater if given within 90 minutes of stroke onset. As a result, there has been a significant push to take stroke care to the patient in the form of the Mobile Stroke Unit (MSU). The MSU is the first designed as a CT-capable ambulance that allows assessment and treatment of stroke patients in the pre-hospital setting. In the proposed research project, we will undertake a clinical trail investigating the effectiveness of a new thrombolytic agent in the MSU, tenecteplase. Tenecteplase has been shown to be significantly more effective at improving stroke survivor’s recovery and opening blocked blood vessels than alteplase in the hospital setting. However, it is unknown if earlier administration of tenecteplase is more effective than early administration of alteplase.
What will be the impact?
The tested agent, tenecteplase, is cheaper, easier to administer (no time-consuming infusions required) and more practical for an ambulance delivered therapy than the current standard of care alteplase. If tenecteplase results in better clinical outcomes in addition to these practical advantages, there is significant scope for improved patient outcomes and cost savings.
RART 2.2 Expansion Activities
Dr Bivard received additional funding in our Rapid Applied Research Translation scheme Round 2 Stage 2 for an expansion on his Stage 1 project. Expansion activities include an increase to the number of community sites and diversification of patients groups, providing an increased generalisability and precision of results.
Download this project summary:
For more information on this project, please contact the MACH office:
(03) 8344 9973