NeurologyLive® Year in Review 2022: Top Stories in Stroke and Cerebrovascular Disease

In 2022, the NeurologyLive^® staff was a busy bunch, covering clinical news and data readouts from around the world across a number of key neurology subspecialty areas. From major study publications and FDA decisions to societal conference sessions and expert interviews, the team spent all year bringing the latest information to the website's front page.

Among our key focus areas is stroke and cerebrovascular disease, a field that has reported massive progress over the past several years, as well as in 2022. Although major news items often appear among the top pieces our team produces, sometimes smaller stories reach those heights for other reasons—clinical impact and interest, or concerns about the small- or big-picture parts of care, for example. Whatever the reason for the attention these stories got, their place here helps provide an understanding of the themes in this field over the course of 2022.

Here, we'll highlight some of the most-read content on NeurologyLive^® this year. Click the buttons to read further into these stories.

1. Chronic Kidney Disease Associated With Increased Risk of Intracerebral Hemorrhage

According to data from a 3-stage study conducted by Guido Falcone, MD, ScD, MPH, and colleagues that combined epidemiologic and genetic analyses, chronic kidney disease was independently associated with a higher risk of intracerebral hemorrhage, regardless of race or ethnicity. In addition, CKD was associated with poor functional outcomes following ICH. The data were published in JAMA Neurology.

2. Alnylam Reports Positive Data on Patisiran in APOLLO-B Trial of ATTR Amyloidosis With Cardiomyopathy

Data announced in late summer from the phase 3 APOLLO-B study (NCT03997383) of patisiran (Onpattro; Alnylam Pharmaceuticals) in patients with transthyretin-mediated amyloidosis with cardiomyopathy suggest that the treatment has met both its primary and first secondary end points. Alnylam noted its plans to use data from the study in a supplemental new drug application to be submitted to the FDA later in the year.

3. The Potential of Sleepio and CBT in the Poststroke Recovery Process

Newly presented data from a study conducted at the University of Oxford by Colin Espie, PhD, and colleagues suggests that Sleepio, a digital therapeutic for the treatment of insomnia, can improve sleep for patients who are undergoing rehabilitation after experiencing a stroke. Espie shared his perspective on the role that cognitive behavioral therapy could play in that care process.

4. FDA Extends Review of Vutrisiran for ATTR Amyloidosis 3 Months, Now Expected in July 2022

Vutrisiran, an investigational subcutaneous RNA interface therapy in development for the treatment of transthyretin-mediated amyloidosis—both hereditary and wild-type—has had its FDA review period extended 3 months, giving the Alnylam product’s new drug application a target review date of late July.

5. Eplontersen Shows Significant Benefits in Hereditary Transthyretin-Mediated Amyloid Polyneuropathy Treatment

New data presented by Teresa Coelho, MD, at the International Symposium on Amyloidosis in Heidelberg, Germany, suggest that the phase 3 NEURO-TTRansform study (NCT04136184) of eplontersen (Ionis, AstraZeneca) was positive, with the investigational treatment for hereditary transthyretin-mediated amyloid polyneuropathy demonstrating significant changes for the coprimary and secondary end points compared with placebo.

6. GammaCore Noninvasive Vagus Nerve Stimulation Demonstrates Safety, Feasibility in Acute Stroke

In the spring, ElectroCore announced that its gammaCore noninvasive vagus nerve stimulation device demonstrated feasibility and a safe profile when treating patients with ischemic or hemorrhagic stroke, according to study results presented by Ethem M. Arsava, PhD, at the 2022 American Academy of Neurology Annual Meeting. On diffusion-weighted imaging, patients saw reductions in relative infarct growth, suggesting efficacious outcomes as well.

7. Tenecteplase Restores Blood Flow Up to 24 Hours Post-Stroke With Limited Hemorrhage Risk

Findings from a phase 2a study (NCT04086147) presented at the 2022 International Stroke Conference by Xin Cheng, MD, PhD, in February showed that administration of tenecteplase between 4.5 to 24 hours from the time of last known well is effective in achieving major reperfusion without symptomatic intracranial hemorrhage in patients with ischemic stroke.

8. Long-Term Statin Use Associated With Lower Risk of Intracerebral Hemorrhage

Results from a population-based, nationwide case-control study of more than 16,000 patients from the Danish Stroke Registry conducted by David Gaist, MD, PhD, showed that current statin use and duration of treatment were associated with decreased risk of intracerebral hemorrhage. The data were published in Neurology.

9. Alteplase With Endovascular Thrombectomy Improves Functional Outcomes, Survival, but With Increased Risk of Symptomatic Intracranial Hemorrhage

An observational study conducted by Eric E. Smith, MD, et al, and published in JAMA Neurology showed that the addition of alteplase to endovascular therapy improves in-hospital mortality and functional outcomes in patients with acute ischemic stroke; however, there was an increased association with symptomatic intracranial hemorrhage.

10. Zoom Stroke Solution Shows Continued Efficacy in Treating Distal Occlusions of Ischemic Stroke

Findings from a study presented by author Collin Torok, MD, at the World Federation of Interventional and Therapeutic Neuroradiology 2022 Annual Meeting highlighted the safety and efficacy of the Zoom Stroke Solution to help patients with middle cerebral artery occlusions achieve reperfusion success.