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New chairman in SITS from 1st of February 2019

Professor Nils Wahlgren will resign as Chairman of SITS International 1st of February 2019 and be replaced by Associate Professor Niaz Ahmed. Nils Wahlgren will remain for some time as SITS senior advisor.

Please find a letter from Nils Wahlgren below.

Dear colleagues and friends in SITS

1st of February 2019 I will leave my position as Chairman of SITS International.Associate Professor Niaz Ahmed will take over. Until now, he has been the SITS Executive Vice Chairman and CEO, so he is well prepared. I am fully confident that with him and the other members of our team; dr Michael Mazya and dr Tiago Moreira, Charlotte Alme, Isa Ek, Linda Ekström, Johan Lundberg and  Shayer Rizvi, the SITS Coordination Team will continue to work perfectly.

I am extremely proud that the SITS network today includes so many highly qualified experts within the stroke field, and that it has become a relevant tool for so many to document clinical information of importance for research and quality evaluations. The creativity within this international network seems incredible, yet, however, not all have detected the possibilities that lie within the SITS database. There is still room for scientific questions to be raised, and the database is open for all active users of SITS.

What have we achieved since the first version of SITS started in the late 1990s? Registration in SITS was one of the conditions for temporary approval of i.v. thrombolysis with alteplase in Europe, according to the decision of the regulatory authority EMEA (now EMA) in 2002. SITS centres collected 6483 patients treated within 3 hours, and the results were published in Lancet in 2007 – the SITS Monitoring Study (SITS MOST). SITS-MOST concluded that iv thrombolysis in clinical practice was as effective and safe as in earlier randomised trials, which contributed to permanent approval of the treatment. Outcomes for patients registered in the time window of 3-4.5 hours were published 2008 in Lancet almost simultaneously with the report from the ECASS III study, which randomised patients for treatment to iv thrombolysis within the time window of 3-4.5 h (the other condition from EMEA). These studies supported prolongation of the treatment window for iv thrombolysis to 4.5 hours after stroke onset. Other SITS publications have among others contributed to support extension of treatment into patients over the age of 80, to patients with diabetes and previous stroke, patients on warfarin with INR 1.7 or lower, and patients with very severe stroke (NIHSS >25). Over 200 co-authors from the SITS network have contributed to publications with clinically important questions and contributed to new knowledge in the field. Close to 70 scientific publications based on SITS data are listed now on the SITS website. Soon publications based on the SITS thrombectomy register will be available.

The development has been incredible; the number of centres and countries working with SITS has increased making SITS a global database and network with active regions in Central and Eastern Europe (SITS EAST), Middle EAST and North Africa (MENA), and Latin America (SIECV SITS). The Subsaharan region is also on its way. Today the number of patient files in the database exceeds 230,000. There are registry protocols not only for i.v. thrombolysis but for thrombectomy, and all general stroke patients. Soon there will be one for intracerebral haemorrhage.  SITS will also take up a continuation of the Central Venous Thrombosis Registry that was previously organised from Lisbon (professor Ferro). Two new important studies, SITS in the Elderly study (a study to document the use of alteplase in 80+ patients) and SITS Pediatric Study (a study to document the use of alteplase in the age group 16-18 years after regulatory extension) are in preparation.

My message to the SITS network members is to join actively, find the protocols relevant for your centre, enter your patients, find the reports that are most useful, and show the results to your colleagues. And be aware of the fact that you, as an active SITS participant, have access to the entire SITS database for your scientific purposes – if you have a scientific question you would like to evaluate using the SITS international data, you can do it. Your proposal will be evaluated by the Scientific Committee, and if approved you will have access to the data you need.

SITS is a great tool, and it is yours.

Nils Wahlgren