Dr. Robert Simister, a consultant to Algernon Pharmaceuticals Inc. (AGN:CSE; AGNPF:OTCQB; AGN0:XFRA), noted that stroke is the primary cause of long-term disability. Anyone, at any age, can suffer a stroke. Resulting damage can be permanent. Simister is a London, England-based physician consultant in Neurology and Stroke Medicine and the London Stroke Clinical Network's clinical director.
Simister explained the medical procedure for when a patient presents after having a possible stroke and why time is crucial to their outcome. After arriving at the hospital or clinic and before treatment can be administered, the patient must undergo a brain scan to determine if they in fact had a stroke and if so, what type: hemorrhagic or ischemic. Hemorrhagic strokes, rarer than ischemic, are caused by an artery suddenly bleeding into the brain.
Ischemic strokes result from a blockage of blood flow to the brain and account for about 85% of patient strokes, Simister noted. Most often it is an artery in the brain that is blocked but it can be any artery in the head, small to main. The larger the blocked vessel, the bigger the volume of tissue at immediate risk of irreversible injury. Regardless of blockage location, the treatment concept is the same, to open the blood vessel as soon as possible, but the approach differs.
With blocked smaller vessels, thrombolysis, injection of a clot busting agent into the vein, is done. Blocked larger vessels require a thrombectomy, or removal of the obstruction. Some patients may be treated both ways to maximize recovery.
"We have minutes to deliver one or both of these treatments," Simister said, referring to stroke treating clinicians. "Time is critical."
Thus, any intervention that could afford physicians a little extra time would be greatly beneficial, and Algernon's DMT, or dimethyltryptamine, might just do that.
Another consultant to Algernon, Dr. Anthony Rudd, described the evolution of stroke care in London from unimpressive to dramatically improved results and the city now being a leader in stroke care quality. Rudd is a past president and an honorary vice president of the British Association of Stroke Physicians and a former clinical director of the London Stroke Clinical Network.
To improve stroke outcomes in London, Rudd and a team developed clinical guidelines, provided education, told hospitals and clinicians what they were doing wrong and could do better. These efforts, though, had little effect; thrombolysis was being performed in only 1–2% of admitted ischemic stroke patients.
About 10 years ago, the team shifted its focus to making structural changes. It reduced the number of centers providing stroke care to eight, one per every 1 million people in the city. It established minimum staff levels for each. It set and required certain standards and financially incentivized hospitals to meet them.
"Overnight, we saw a dramatic improvement in the quality of care that patients would be expected to receive," Rudd said. "It was just the most exciting piece of work that I was involved in in my career."
Patients arrived at the stroke centers faster, and the percentage of admitted ischemic stroke patients getting thrombolysis procedure grew to 12–13%. This percentage compares to the global average of between 2% and 10%, Algernon CEO Christopher Moreau said.
Even with this improved percentage, he pointed out, about 80–85% of ischemic stroke patients still are not getting treatment. Instead, they are stabilized and monitored. This population represents a large number of people who could benefit from DMT.
The fact that DMT is a psychedelic drug does not make Rudd skeptical about using it as a medical treatment, he said. The DMT dose that would be used in stroke patients would be sub-psychedelic, noted Moreau. Thus, it would not cause hallucinations and/or other symptoms commonly experienced with psychedelics.
In moving forward with DMT clinical trials, despite the drug being safe, stroke patients' co-morbidities may affect how they tolerate it, Rudd said, "but my hope is that we can answer those questions very quickly and get on and do the sort of trials to see whether it really can help this particular group of patients because we desperately need more treatments available for them."
Simister explained why DMT is compelling in terms of stroke care. It could protect the brain from the original injury, buy time for treatment delivery, protect the brain from the secondary injury of inflammatory response and help brain cells regenerate after the injury.
"If [DMT] is capable of buying some time to allow us to deliver our time-critical treatments with less injury or to get to a treatment center quicker and still have salvageable brain, that will be tremendous," Simister said.
"If it's capable of being anti-inflammatory and so reduce the ongoing injury that happens after the stroke, that will be a second major win.
And if it then, at some point after stroke, is capable of being harnessed as part of a therapeutic rehabilitation program then it could be very significant in a third way."
Should DMT prove effective, Moreau expects that physicians and regulatory agencies worldwide would welcome it.
If Simister's sentiment about the psychedelic's prospects for stroke is any indication, widespread adoption is likely.
"DMT looks to be a really very exciting opportunity for us along the whole phase of stroke recovery," he said. "How incredible if we see this happen in our lifetime."
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- Christopher J. Moreau - Chief Executive Officer owns securities of the company.
- Disclosures for: Dr. Anthony Rudd, MB, BChir, FRCP, CBE - Medical Consultant. I, or members of my immediate household or family, own securities of the following companies discussed in the broadcast: None. I personally am, or members of my immediate household or family are, paid by the following companies discussed in the broadcast: Algernon Pharmaceuticals Inc. My company has a financial relationship with the following companies discussed in the broadcast: Algernon Pharmaceuticals Inc.
- Disclosures for: Dr. Robert Simister, MA, MB, BS, PhD, FRCP - Medical Consultant. I, or members of my immediate household or family, own securities of the following companies discussed in the broadcast: None. I personally am, or members of my immediate household or family are, paid by the following companies discussed in the broadcast: Algernon Pharmaceuticals Inc. My company has a financial relationship with the following companies discussed in the broadcast: Algernon Pharmaceuticals Inc.
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