Tenecteplase has similar safety to tissue plasminogen activator for acute ischemic stroke

For patients with 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 online Oct. 16 in Neurology.

Lina Palaiodimou, M.D., Ph.D., from the National and Kapodistrian University of Athens in Greece, and colleagues conducted a systematic review and meta-analysis of all available randomized controlled trials (RCTs) that examined the efficacy and safety of TNK 0.25 mg/kg versus TPA for treatment of AIS within 4.5 hours of onset. Data were included for 11 RCTs, with 3,788 patients treated with TNK and 3,757 patients treated with TPA.

The researchers found that compared with TPA, TNK was associated with a higher likelihood of excellent functional outcome (risk ratio, 1.05) and reduced disability at three months (common odds ratio, 1.10), while the groups had similar improved functional outcome. Similar rates of symptomatic intracranial hemorrhage and three-month mortality were observed in the groups. Statistical significance in achieving an excellent functional outcome at three months was retained for the original TNK when stratified for TNK regimen (original versus biocopy; risk ratio, 1.05).

“It demonstrates that TNK is associated with better clinical outcomes, showing superiority over TPA in achieving excellent functional outcome and reduced disability at three months. These findings support transitioning to TNK in clinical practice,” the authors write.

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