Field Administration of Stroke Therapy-Magnesium trial will include paramedics and nearly 80 hospitals in Los Angeles County

The David Geffen School of Medicine at UCLA announced Sept. 25 that the National Institutes of Health has awarded a $16 million grant to a multi-hospital effort led by the UCLA Stroke Center to perform a pivotal trial of a new therapy for acute stroke.

The Field Administration of Stroke Therapy-Magnesium (FAST-MAG) trial will examine if magnesium sulfate can protect the threatened brain when administered to stroke victims by paramedics within the first two hours of stroke onset. Magnesium sulfate works by dilating brain blood vessels and by preventing buildup of damaging calcium in injured nerve cells.

The National Institutes of Health-funded FAST-MAG trial is the first large-scale trial of neuroprotective therapy delivery to stroke patients in ambulances.

“Time is of the essence in treating acute stroke,” said Dr. Jeffrey Saver, study principal investigator and professor of neurology at the David Geffen School of Medicine at UCLA. “By utilizing paramedics to deliver a brain-protecting agent for the first time ever in a large trial, we hope to pioneer a new, more successful era in stroke therapy.”

The grant will be awarded over the next four years with UCLA Medical Center serving as the clinical coordinating center. The groundbreaking trial will be conducted at up to 80 hospitals in Los Angeles County and include 1,298 stroke patients who will be randomized to receive magnesium sulfate, or a placebo.

The initial pilot study, conducted from May 2000 to January 2002, showed promising results — that paramedics in the field initiated the drug much more quickly compared to the usual approach of waiting until the patient was in the hospital, and that patients showed a tendency to better recovery.

“The pilot trial showed that paramedics can recognize stroke accurately and safely start magnesium sulfate in the field,” said Dr. Marc Eckstein, medical director of the Los Angeles Fire Department and co-principal investigator for the study. “Now, we need to perform the large pivotal trial to determine definitively if early magnesium sulfate improves patient outcome.”

The FAST-MAG trial will be performed in conjunction with paramedics from the Los Angeles Fire Department, as well as emergency physicians, neurologists and nurses throughout Los Angeles County.

The UCLA Stroke Center is recognized globally as a leader in the treatment of stroke and is committed to research and advancements in stroke therapy. The UCLA Stroke Center team includes experts in the fields of emergency medicine, stroke neurology and interventional neuroradiology.