Photo Credit: Peterschreiber.media

For acute ischemic stroke (AIS), tenecteplase (TNK) has improved functional outcome and reduced disability and similar safety to alteplase (tissue plasminogen activator [TPA]), according to a study published in Neurology. Georgios K. Tsivgoulis, MD, PhD, MSc, and colleagues analyzed randomized controlled trials (RCTs) on the efficacy and safety of TNK 0.25 mg/kg versus TPA for treatment of AIS within 4.5 hours of onset. 11 RCTs included Data with 3,788 patients treated with TNK and 3,757 patients treated with TPA. TNK was associated with a higher probability of excellent functional outcome (risk ratio [RR], 1.05) and reduced disability at 3 months (common OR, 1.10) compared to TPA. The groups had a similarly improved functional outcome, as well as similar rates of symptomatic intracranial hemorrhage and 3-month mortality. The original TNK regimen resulted in statistical significance for an excellent functional outcome at 3 months when stratified. “These findings support transitioning to TNK in clinical practice,” Dr. Tsivgoulis and colleagues wrote.