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Recently, two large trials have shown that tenecteplase is noninferior to alteplase in the treatment of patients with acute ischemic stroke in the <4.5-hour time window. These trials used standard brain imaging and did not include perfusion imaging of the brain. A new partially manufacturer-funded trial (TASTE) compares the two thrombolytic agents and also used perfusion imaging. Researchers randomly assigned patients with acute stroke who could be treated within 4.5 hours to tenecteplase (0.25 mg/kg) or alteplase (0.9 mg/kg). The primary outcome was excellent neurologic outcome at 90 days (modified Rankin Scale score, 0–1). Symptomatic intracranial hemorrhage (sICH) and mortality were safety outcomes.
The trial enrolled 680 patients, with d…