Update on Alteplase and Tenecteplase shortage – ESO Statement and Information
On April 14, the ESO published their 4th information letter about alteplase and tenecteplase shortage in Europe.
UPDATE ON THROMBOLYTIC DRUG SHORTAGE
UPDATE ON THROMBOLYTIC DRUG SHORTAGE
UPDATE ON THROMBOLYTIC DRUG SHORTAGE
Thrombolytic drug shortage is expected to last until 2024. The manufacturing company is limiting supply to all countries worldwide. Currently, the impact on future drug delivery is still unclear. However, for the month October, drug delivery will be further restricted.
Additionally, the production of Actosolv, mainly used for IV cathether obstruction, has not yet been resumed and will likely become unavailable from January 2023.
With the help of Belgian experts, FAGG/AFMPS has released guidance for hospital pharmacists and medical doctors concerning the shortage of thrombolytic drugs. The guideline serves the purpose of making other medical specialities aware of the shortage and restricting the use of thrombolytics for non-urgent indications. Centralisation of hospital stock and monitoring of local usage is highly recommended. With regards to treatment of ischemic stroke, increased use of MRI or CT perfusion imaging is recommended to avoid treating stroke mimics as much as possible, avoiding off-label alteplase use and optimalisation of alteplase dosing using complete vials of 20 and 50mg, taking into account local availability of both dosages, is advised to avoid wastage.
Some guidelines for rational use of tPA:
Avoiding tPA wastage by limiting the use of 2x 50mg vials and rounding to full vial dosages. As a rule of thumb we suggest:
- 60 kg: 1 x 50 mg
- 70 kg: 3 x 20 mg
- 80 kg: 1 x 20 mg + 1 x 50 mg
- 90 kg: 4 x 20 mg
- from 100 kg: 2 x 20 mg + 1 x 50 mg
Read also the FAGG recommendation here
Dutch: https://tinyurl.com/4hf5xvxp
French: https://tinyurl.com/c7av4k4c
See also additional guidance by the European Stroke Organization and the Advisory board Thrombolytics – Boehringer Ingelheim:
Recognize stroke – get acquainted with the FAST score
Treatment of brain infarct becomes less effective over time. Earlier hospital admission and treatment may help avoid disability.
The Face-Arm-Speech-Time (FAST) score teaches us the most common symptoms of stroke, in order to recognize it faster and get treated!
Click on the images to see the FAST score explained!
Stroke Action Plan Europe – 11 May
For the European Stroke Awareness Day (May the 11th), The European Stroke Organisation and the Stroke Alliance for Europe are asking Europe officials to sign the Declaration of the Stroke Action Plan Europe (SAP-E).
Two members of the Belgian Stroke Council are involved in contacting the Belgian Authorities: Prof Sylvie de Raedt (Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel) en Dr Matthieu Rutgers (Cliniques de l’Europe, Bruxelles).
Sylvie.deraedt@uzbrussel.be
M.Rutgers@cdle.be
Belgian Stroke Council: info@belgianstrokecouncil.be
Persbericht
Brief aan de ministers
Thrombocytopenia with thrombosis after COVID-19 vaccination – statement from the Belgian Society on Thrombosis and Haemostasis
The Belgian Society on Thrombosis and Haemostasis recently published a practice guideline on the rare occurrence of Thrombocytopenia with Thrombosis after COVID-19 Vaccination. We encourage all Belgian neurologists to consult the information on their website.
Post stroke checklist
La check-list post-AVC a été conçue par le Global Stroke Community Advisory Panel en 2012, a été validée par l’Organisation Mondiale de l’AVC (WSO) et adaptée par le Belgian Stroke council en 2016. Ce document peut vous aider à préparer votre prochaine consultation chez votre neurologue.