New Drug Cuts Second Stroke Risk 26% Without Bleeding

Stroke survivors have a powerful new reason for hope. Researchers testing a medication called asundexian discovered it cuts the risk of a second stroke by 26% without the bleeding dangers that limit current treatments.

The findings come from a massive international study tracking more than 12,300 stroke survivors for up to 31 months. Lead researcher Dr. Mike Sharma from McMaster University calls it "a major advance in our ability to prevent strokes in people at risk of stroke recurrence."

The stakes are high. Nearly 1 in 4 stroke survivors will experience another stroke, and current prevention options are limited. Doctors typically prescribe antiplatelet medications like aspirin to prevent blood clots, but these drugs only work so well.

Adding stronger blood thinners helps prevent clots but comes with a serious tradeoff. They significantly increase bleeding risk, making them unsuitable for long-term use in most patients.

Asundexian works differently. It targets a specific clotting protein called Factor XI, which helps form the large blood clots that block blood vessels and cause strokes. Interestingly, people born without this protein naturally have fewer strokes and rarely experience spontaneous bleeding.

In the trial, participants took either standard antiplatelet therapy plus asundexian or antiplatelet therapy plus a placebo. The results showed consistent benefits across all patient groups, regardless of age, sex, or stroke severity.

Beyond reducing strokes, asundexian also lowered disabling strokes and showed no increase in brain bleeding or other serious side effects. The medication even reduced overall cardiovascular deaths, heart attacks, and strokes of any type.

The Ripple Effect

This breakthrough could transform care for millions. The medication worked for all types of non-cardioembolic strokes, not just those caused by plaque buildup in arteries. That means more patients could benefit if the FDA approves the drug.

Dr. Sharma notes that previous attempts to improve stroke prevention by combining medications failed because they either increased bleeding risk, showed no benefit, or both. Asundexian breaks that pattern by offering protection without the dangerous tradeoffs.

The research team collected brain imaging data from participants to further understand how asundexian works. Those results are still being analyzed but should provide additional insights into the medication's impact.

For stroke survivors living with the fear of another attack, asundexian represents something medicine has struggled to deliver: better protection without worse risks.