Is Tenecteplase the Preferred Thrombolytic Agent for Acute Ischemic Stroke?

In a randomized trial, tenecteplase was as safe as alteplase, but not more effective.

Alteplase is currently the only FDA-approved thrombolytic medication for acute stroke. Tenecteplase is a bioengineered compound with greater fibrin specificity and a longer half-life than alteplase. A small, multicenter, phase 2 trial (NEJM JW Neurol Mar 2012) showed higher rates of reperfusion and improved clinical outcome with tenecteplase than with alteplase.

In this multicenter, phase 3 trial, 1100 adults with suspected acute ischemic stroke at 13 centers in Norway were randomly assigned to receive either tenecteplase (0.4 mg/kg up to a maximum of 40 mg) or alteplase (0.9 mg/kg up to a maximum of 90 mg). Patients were eligible if they could be treated within 4.5 hours of either stroke onset or awakening with symptoms. The primary outcome…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Is Tenecteplase the Preferred Thrombolytic Agent for Acute Ischemic Stroke?

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Reviewing Author