The University of Texas Health Science Center at Houston (UTHealth) has been named one of 25 regional stroke centers by the National Institutes of Health (NIH) and the only one in Texas.
"That UTHealth is the only center with this designation in the state and region, speaks to our track record of delivering the highest quality care and our long-standing tradition of being one of the best stroke centers in the nation," said Giuseppe N. Colasurdo, M.D., president of UTHealth.
The network of 25 regional stroke centers working with nearby satellite facilities will span the country, have teams of researchers representing every medical specialty needed for stroke care and will address the three prongs of stroke research: prevention, treatment and recovery.
The UTHealth center's principal investigator is Sean I. Savitz, M.D., the Frank M. Yatsu, M.D., Chair in Neurology. Satellites include The University of Texas Health Science Center at San Antonio and Tulane University School of Medicine with a plan to conduct stroke research throughout the Gulf area. More sites from throughout the southern regions of the country are expected to join.
"The new system is intended to streamline stroke research by centralizing approval and review, lessening time and costs of clinical trials, and assembling a comprehensive data sharing system," said Petra Kaufmann, M.D., the associate director for clinical research at the National Institute of Neurological Disorders and Stroke (NINDS).
NINDS, which will fund and manage the NIH Stroke Trials Network, or NIH StrokeNet, has a strong history of successful stroke clinical trials over the past 40 years, leading to some astonishing advances in treatment and prevention of the disease, including the first treatment for acute stroke, announced in 1995.
The 25 centers are strategically placed in every region of the country. Successful applicants demonstrated experience in stroke research and recruitment, including the ability to enroll underrepresented populations, and were required to offer access to the full cadre of specialties that are involved in stroke care. These include emergency medicine, neurosurgery, interventional neuroradiology, vascular neurology, neurointensive care, neuroimaging, stroke rehabilitation and pediatric neurology.
UTHealth and Memorial Hermann-Texas Medical Center were among the original six sites that tested the only known treatment for stroke: tissue plasminogen activator (tPA). Researchers at UTHealth are currently testing add-on medications to tPA, ultrasound combined with tPA, cooling of the brain and a clot-buster based on vampire bat saliva. They are one of the first centers in the country to test stem cell therapies.
Each center will receive five years of funding, with $200,000 in research costs and $50,000 for training stroke clinical researchers per year over the first three years, and additional funds driven by the completion of milestones. The University of Cincinnati will manage the national clinical coordinating center, which will oversee and coordinate the institutional review board and master trial agreements for all of the regional centers. NIH will announce the award of a national data management center in February.
NIH StrokeNet investigators, working with the broader stroke community, will propose, develop and conduct stroke protocols to be administered within the network and train the future generation of clinical researchers in stroke.
Historically, the model for stroke clinical trials was to complete large teams of personnel and infrastructure, which were then disassembled once the trial was completed. This led to delays in patient recruitment and additional costs when new trials were initiated, with some stroke clinical trials lasting many years longer than anticipated and costing millions of dollars more than the original estimate.
In a 2013 article in Stroke, Story Landis, Ph.D., NINDS director, and co-author Marc Fisher, M.D. write: "Because our ultimate goal is to test and compare therapies that will have a real impact on patient health, a coordinated and long-range approach to solving challenges in stroke trial research is sorely needed."
The network concept evolved from an NINDS planning effort in which stroke experts were asked what is most needed to reduce death and disability due to stroke in the United States. They called for a nationwide stroke network that would allow for a more seamless transition between early safety and efficacy trials and Phase II and III clinical trials.
"NIH StrokeNet will allow the most promising therapies to quickly advance to the clinic, to improve prevention, acute treatment, or rehabilitation of the stroke patient," said Walter J. Koroshetz, M.D., NINDS deputy director. "We need to have a balance of approaches to decrease the burden of illness due to stroke."
"Our goal for the NIH Stroke Centers Network is to initiate four to five NINDS-funded exploratory Phase I and II stroke clinical trials, and two to four Phase III trials over the next five years. This is a major challenge which we believe the stroke research community will embrace," said Scott Janis, Ph.D., NINDS program director of the NIH StrokeNet.