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Comparing Tenecteplase and Alteplase for Acute Ischemic Stroke.

Chen-Chen Tu, Hanqi Kelly Mao, Jennifer L Wessol

    The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
    |February 12, 2025
    PubMed
    Summary
    This summary is machine-generated.

    Tenecteplase (TNK) is as effective and safe as alteplase (tPA) for acute ischemic stroke (AIS) treatment, offering significant cost savings and potentially faster administration. This makes TNK a valuable alternative, especially in resource-limited settings.

    Keywords:
    Tenecteplaseacute ischemic strokealteplasecost-effectivenessquality improvementthrombotic

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    Area of Science:

    • Neurology
    • Pharmacology
    • Health Economics

    Background:

    • Acute ischemic stroke (AIS) is a major cause of death and disability.
    • Prompt thrombolytic therapy improves patient outcomes.
    • Alteplase (tPA) is FDA-approved, but tenecteplase (TNK) is a recommended alternative.

    Purpose of the Study:

    • Compare cost-effectiveness and clinical outcomes of TNK versus tPA in AIS treatment.
    • Evaluate key metrics: door-to-needle time, length of stay, NIH Stroke Scale scores, and hemorrhagic conversion rates.

    Main Methods:

    • Retrospective analysis of 175 AIS patients at a community hospital.
    • Data collected from March 2022 to December 2023.
    • Patients received tPA before March 15, 2023, and TNK thereafter, adhering to AHA guidelines.

    Main Results:

    • Door-to-needle times were similar, but TNK showed a significant advantage when outliers were excluded (P=.04).
    • No significant differences in demographics, NIH Stroke Scale scores, length of stay, or post-hemorrhage rates.
    • TNK use resulted in over $40,000 in medication cost savings.

    Conclusions:

    • TNK demonstrates comparable safety and efficacy to tPA for AIS treatment.
    • TNK offers significant cost savings and ease of administration, making it attractive for resource-limited settings.
    • Results support organizational protocols favoring TNK for AIS treatment.