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Less common than ischemic stroke, hemorrhagic stroke is nevertheless more destructive. Unfortunately, no treatment currently exists. But Bioxodes, a Belgian biotechnology company, is currently testing an astonishing solution. Doctissimo met Hans Warrinnier, its medical director.
The second leading cause of death in the world, stroke has two forms: ischemic stroke, which is caused by a blood clot blocking an artery and depriving the brain of oxygen, and hemorrhagic stroke, which as the name suggests is bleeding. Faced with this second threat, no solution is currently available. But a new test drug studied in Belgium by the company Bioxodes could change the situation in the coming years. Its medical director, Dr. Hans Warrinnier, tells us about it.
Hemorrhagic stroke, a more formidable form
Hemorrhagic stroke is less known than ischemic stroke by the general public. “Let’s say that it’s not always easy for people to tell the difference.” admits Dr. Hans Warrinnier. And for good reason, ischemic stroke, this famous blood clot that blocks an artery, represents 85% of all strokes, the vast majority. He benefits from various treatments to relieve and care for the patient.
“Hemorrhagic stroke only represents 15% of strokes, but 40% of deaths! Its impact is therefore greater and its damage more serious.”
As the name suggests, this is a brain bleed.spontaneous in the majority of cases, although it can also occur after trauma. underlines the expert. Between 5 ml and 80 ml of blood, which escapes and settles in the brain. And against which unfortunately there are no solutions to date. “In the worst case, surgery is necessary to drain the blood if there is too much tension in the brain. In the rest, i.e. 85% of cases, for the moment we do not know how to do anything. We will support the patient, try to lower his high blood pressure which is making things worse… and pray.” advances the expert, sarcastically.
A new tick-derived protein as a solution
In this very pessimistic state of affairs, Bioxodes, a Belgian biotechnology company hopes to provide a unique solution because it is currently working on BIOX-101. This test drug does not promise to prevent hemorrhagic stroke, but may reduce its side effects and allow the victim to recover. This amazing medicine is based on a protein, derived from the saliva… of the tick. “The tick is very clever, because to feed on the blood of its host, it uses an anticoagulant, which thins the blood, but does not make it bleed more. explains the expert. Its saliva also has the property of being anti-inflammatory, which prevents the tick from being discovered. Two particularly interesting properties in the treatment of hemorrhagic stroke.
“In the event of a stroke, the body wants to defend itself, which causes a thrombo-inflammatory reaction in the brain. There is both the risk of forming small clots, but also a very significant local inflammatory reaction, directed by white blood cells called neutrophils within 4 to 6 hours following the accident. What we are studying with this protein is its ability to resolve coagulation problems without causing more bleeding, but also to reduce the impact of this activation of neutrophils.
Promising trials, to be confirmed in 2025
What is the treatment like? This is what the team is currently evaluating in a phase 2a trial for maximum safety. To minimize the negative effects, the doctor is now testing a continuous 48-hour infusion, which would have an anti-coagulant effect for 3 days. “If we act at the start of the primary event, and for 48 hours, our results today demonstrate that we avoid long-term damage, side effects, and that the patient recovers better.”
According to the doctor, the next results are eagerly awaited by many neurologists as the options are currently reduced. But they require even more data. Bioxodes is currently recruiting 32 test patients and will submit its main report in 2025… before starting an international study this time.
Slide: Everything you need to know about stroke and its symptoms