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Tenecteplase is a thrombolytic agent with potential advantages over alteplase, including the ability to give it as a bolus injection. Earlier trials have suggested that tenecteplase is noninferior to alteplase; replication of these findings in a different setting would bolster the case in favor of tenecteplase. Now, investigators report results of a randomized trial in the United Kingdom for patients with acute ischemic stroke who could be treated within 4.5 hours of stroke onset. Patients were randomized to tenecteplase (0.25 mg/kg) or alteplase (0.9 mg/kg). The primary outcome was the distribution of modified Rankin Scale (mRS) scores at 90 days. Symptomatic intracerebral hemorrhage (sICH) was one of the safety measures.
Over the trial per…