Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review

Area of Science:

• Neurology
• Pharmacology
• Clinical Trials

Background:

• Alteplase is the standard thrombolytic for acute ischemic stroke (AIS) within 4.5 hours.
• Tenecteplase, a modified alteplase, shows potential for improved outcomes, lower cost, and easier administration.
• Interest is growing in tenecteplase as an alternative thrombolytic therapy for AIS.

Purpose of the Study:

• To systematically review and compare the efficacy of tenecteplase versus alteplase in treating acute ischemic stroke.
• To evaluate three key outcomes: symptomatic hemorrhage, 90-day functional outcome, and reperfusion grade after thrombectomy.
• To determine if tenecteplase offers superior results to alteplase in AIS management.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) published in English.
• PubMed database search conducted in August 2021 using the primary term 'tenecteplase for acute stroke'.
• Inclusion of 6 RCTs involving 1675 patients with AIS.

Main Results:

• No single study directly compared tenecteplase and alteplase across all three specified outcomes.
• The review synthesized data from multiple studies to assess comparative efficacy.
• Evidence suggests potential advantages of tenecteplase over alteplase in AIS treatment.

Conclusions:

• Current evidence indicates that tenecteplase is a potentially better thrombolytic agent for acute ischemic stroke.
• Tenecteplase may offer improved efficacy compared to alteplase in AIS patients.
• Further research may confirm tenecteplase's advantages in AIS thrombolysis.