Methodology for the Canadian Activase For Stroke Effectiveness Study (CASES)

Background. Intravenous recombinant tissue plasminogen activator (tPA, alte plase) was conditionally licensed for the treatment of acute ischemic strok e (AIS) in Canada on February 17, 1999. As a condition of licensure, the Ca nadian Activase for Stroke Effectiveness Study (CASES) was established to m onitor the use of alteplase for AIS in Canada. The study involves multiple stakeholders. Methods: CASES is a prospective registry of patients treated with alteplase for AIS. The purposes of this registry are to ensure the saf ety of the drug in the Canadian context, to assess effectiveness of altepla se for AIS and to gather further information to try to establish which pati ents are most likely to benefit from treatment. Results: Both community (n= 25) and tertiary centres (n=35) have enrolled a total of 944 patients to da te. Early results suggest that thrombolytic stroke treatment is both safe a nd effective among these centres. Conclusions: This paper outlines the deve lopment of and methods for the CASES study. The study is an example of a mu lti-stakeholder collaboration to advance the care of patients with acute st roke.