Condition

Ischemic stroke

Clinical trials and treatment information for Ischemic stroke

69.9M
People Affected
300
Active Trials
1.4M
New Cases/Year
3.6M
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Endovascular Thrombectomy
90% Effectiveness• 95% Confidence• 50% Safety• 229 trials• 8K participants
HIGH EvidenceExcellent Value
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
50
DangerousModerateSafe

Time to Effect

immediate

Duration

Single procedure

Response Rate

50%

Remission Rate

50%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

20

Common Side Effects:

Symptomatic Intracranial Hemorrhage: 8%
Vessel dissection/perforation: 3%
Infection: 1%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,200

Side Effects

$0

Total Annual

$1,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

2

ICER

$30,000/QALY

Cost per Remission

$75,000

Cost per Responder

$75,000

Treatment Outcomes
Primary Outcomes
Modified Rankin Scale (mRS) score (0-6 scale) at 90 daysMedian mRS 4.5
-33.33% (-1.5 points)
NIHSS Score (0-42 scale) at 24 hours17 points
-41.18% (-7 points)
Proportion of patients with functional independence (mRS 0-2) at 90 days28% (with medical therapy alone)
+60.71% (+17%)
Secondary Benefits
All-cause mortality at 90 days19% (with medical therapy alone)
-42.11% (-8%)
Symptomatic Intracranial Hemorrhage (sICH) rate5% (with medical therapy alone)
+40% (+2%)
Hospital Length of Stay10 days
-30% (-3 days)
Common Side Effects
Symptomatic Intracranial Hemorrhage
+8%
Vessel dissection/perforation
+3%
Infection
+1%

Clinical Trial Phases:

Phase 3Phase 4
2
Alteplase (Intravenous Thrombolysis)
85% Effectiveness• 95% Confidence• 45% Safety• 108 trials• 25K participants
HIGH EvidenceExcellent ValueDose: 0.9 mg/kg IV (max 90 mg) over 60 min (10% bolus, rest infusion)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe

Time to Effect

immediate

Duration

Single administration

Response Rate

35%

Remission Rate

35%

Number Needed to Treat (NNT)

9

Number Needed to Harm (NNH)

25

Common Side Effects:

Symptomatic Intracranial Hemorrhage: 5%
Systemic bleeding (GI, GU): 8%
Angioedema: 1%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,200

Side Effects

$0

Total Annual

$1,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

1

ICER

$40,000/QALY

Cost per Remission

$60,000

Cost per Responder

$60,000

Treatment Outcomes
Primary Outcomes
Functional Independence (mRS 0-2) at 90 daysProbability of mRS 0-2 (without alteplase): 30%
+33.3% (+10 percentage points)
National Institutes of Health Stroke Scale (NIHSS) score at 24 hoursAverage NIHSS score: 14/42 (moderate-severe stroke)
-28.6% (-4 points)
Excellent Neurological Outcome (NIHSS 0-1) at 90 daysProbability of NIHSS 0-1 (without alteplase): 20%
+40% (+8 percentage points)
Secondary Benefits
Quality of Life (EQ-5D VAS) score at 90 daysEQ-5D VAS score: 50/100
+20% (+10 points)
Barthel Index score at 90 daysBarthel Index score: 60/100 (moderate dependency)
+25% (+15 points)
Hospital Length of StayAverage hospital stay: 10 days
-20% (-2 days)
Common Side Effects
Symptomatic Intracranial Hemorrhage
+5%
Systemic bleeding (GI, GU)
+8%
Angioedema
+1%

Clinical Trial Phases:

Phase 3Phase 4
3
Dual Antiplatelet Therapy (Aspirin + Clopidogrel)
80% Effectiveness• 90% Confidence• 70% Safety• 29 trials• 20K participants
HIGH EvidenceExcellent ValueDose: Aspirin 75-325mg loading, 75-100mg daily; Clopidogrel 300-600mg loading, 75mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

days to weeks

Duration

21-90 days

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

50

Number Needed to Harm (NNH)

250

Common Side Effects:

Major Bleeding (non-ICH): 1%
Minor Bleeding: 8%
Dyspepsia: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,200

Side Effects

$0

Total Annual

$1,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$5,000/QALY

Cost per Responder

$400

Treatment Outcomes
Primary Outcomes
Risk of New Ischemic Stroke (90-day incidence)9.2%
-29.3% (-2.7%)
Risk of Any New Stroke (Ischemic or Hemorrhagic) (90-day incidence)11.7%
-30% (-3.5%)
Risk of Severe Hemorrhage (major or life-threatening bleeding, 90-day incidence)0.1%
+200% (+0.2%)
Secondary Benefits
Risk of New Ischemic Stroke or TIA (90-day incidence)14.3%
-29.4% (-4.2%)
Proportion of Patients with Excellent Functional Outcome (mRS 0-1) at 90 days80%
+6.3% (+5%)
Risk of Myocardial Infarction (90-day incidence)0.3%
-33.3% (-0.1%)
Common Side Effects
Major Bleeding (non-ICH)
+1%
Minor Bleeding
+8%
Dyspepsia
+7%

Clinical Trial Phases:

Phase 3Phase 4
4
Long-term Antiplatelet Therapy (Aspirin)
75% Effectiveness• 95% Confidence• 80% Safety• 5 trials• 200K participants
HIGH EvidenceExcellent ValueDose: 75-100 mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

months to years

Duration

lifetime

Response Rate

18%

Remission Rate

%

Number Needed to Treat (NNT)

40

Number Needed to Harm (NNH)

300

Common Side Effects:

Gastrointestinal bleeding: 1.5%
Dyspepsia: 5%

Annual Cost of Care

Drug Cost

$30

Monitoring

$50

Side Effects

$50

Total Annual

$130

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.3

ICER

$1,000/QALY

Cost per Responder

$722

Treatment Outcomes
Primary Outcomes
Risk of Recurrent Ischemic Stroke8% annual risk
-22% (-1.76% absolute annual risk reduction)
Risk of Major Vascular Events (Composite)12% annual risk
-17% (-2.04% absolute annual risk reduction)
Platelet Aggregation Response (ADP-induced)70% aggregation
-40% (-28% absolute reduction in aggregation)
Secondary Benefits
Risk of Non-fatal Myocardial Infarction4% annual risk
-30% (-1.2% absolute annual risk reduction)
All-cause Mortality15% annual risk
-10% (-1.5% absolute annual risk reduction)
Risk of Peripheral Artery Disease Events3% annual risk
-20% (-0.6% absolute annual risk reduction)
Common Side Effects
Gastrointestinal bleeding
+1.5%
Dyspepsia
+5%

Clinical Trial Phases:

Phase 3Phase 4
5
Apixaban (Anticoagulation for AFib-related stroke)
70% Effectiveness• 95% Confidence• 65% Safety• 10 trials• 70K participants
HIGH EvidenceGood ValueDose: 5 mg BID
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

days

Duration

lifetime

Response Rate

65%

Remission Rate

%

Number Needed to Treat (NNT)

30

Number Needed to Harm (NNH)

150

Common Side Effects:

Major bleeding (ICH, GI): 2%
Minor bleeding: 15%

Annual Cost of Care

Drug Cost

$6,000

Monitoring

$150

Side Effects

$300

Total Annual

$6,450

Cost-Effectiveness

GOOD

QALYs Gained

1

ICER

$45,000/QALY

Cost per Responder

$9,923

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+70%
Response Rate
+65%
Common Side Effects
Major bleeding (ICH, GI)
+2%
Minor bleeding
+15%

Clinical Trial Phases:

Phase 3Phase 4
6
Atorvastatin (Statin Therapy)
70% Effectiveness• 95% Confidence• 65% Safety• 24 trials• 200K participants
HIGH EvidenceExcellent ValueDose: 10-80 mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

months to years

Duration

lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

25

Number Needed to Harm (NNH)

250

Common Side Effects:

Myalgia: 7%
Liver enzyme elevation (non-serious): 2%
New-onset diabetes: 0.8%

Annual Cost of Care

Drug Cost

$50

Monitoring

$100

Side Effects

$100

Total Annual

$250

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.5

ICER

$5,000/QALY

Cost per Responder

$1,000

Treatment Outcomes
Primary Outcomes
Risk of Recurrent Ischemic Stroke12% 5-year cumulative risk
-16% (-1.9 percentage points (absolute reduction in 5-year risk))
Major Adverse Cardiovascular Events (MACE)20% 5-year cumulative risk
-20% (-4.0 percentage points (absolute reduction in 5-year risk))
LDL Cholesterol125 mg/dL
-45% (-56 mg/dL)
Proportion with Good Functional Outcome (mRS 0-2)45% achieving mRS 0-2
+6.7% (+3 percentage points)
Secondary Benefits
HDL Cholesterol45 mg/dL
+5% (+2.3 mg/dL)
High-sensitivity C-Reactive Protein (hs-CRP)3.0 mg/L
-18% (-0.54 mg/L)
Total Cholesterol200 mg/dL
-35% (-70 mg/dL)
Common Side Effects
Myalgia
+7%
Liver enzyme elevation (non-serious)
+2%
New-onset diabetes
+0.8%

Clinical Trial Phases:

Phase 3Phase 4
7
Lisinopril (Blood Pressure Lowering)
65% Effectiveness• 95% Confidence• 70% Safety• 200 trials• 200K participants
HIGH EvidenceExcellent ValueDose: 10-40 mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

days to weeks

Duration

lifetime

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

30

Number Needed to Harm (NNH)

500

Common Side Effects:

Cough: 7%
Dizziness/Hypotension: 3%
Angioedema: 0.5%

Annual Cost of Care

Drug Cost

$50

Monitoring

$100

Side Effects

$100

Total Annual

$250

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.5

ICER

$5,000/QALY

Cost per Responder

$1,000

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+25%
Common Side Effects
Cough
+7%
Dizziness/Hypotension
+3%
Angioedema
+0.5%

Clinical Trial Phases:

Phase 3Phase 4