Better Outcomes with Tenecteplase vs. Alteplase for Confirmed Large-Vessel Occlusion Stroke

A meta-analysis of this subgroup finds 3-month disability outcomes and recanalization rates are improved with tenecteplase compared with alteplase.

Alteplase remains the only FDA-approved thrombolytic for acute ischemic stroke. Tenecteplase, a modified tissue plasminogen activator, binds more selectively and has a longer half-life that allows it to be administered as a single bolus rather than the bolus and continuous infusion required for alteplase. A comprehensive meta-analysis of the one large randomized trial and the four smaller phase 2 trials completed to date suggested that tenecteplase may be superior to alteplase for recanalization and noninferior for 3-month disability outcomes (Stroke 2019; 50:2156).

Within this context, researchers recently conducted a more selective systematic review and meta-analysis comparing tenecteplase and alteplase based on some of these same trials b…

Reviewing Authors

Danielle B. Cross, MD, MS

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Better Outcomes with Tenecteplase vs. Alteplase for Confirmed Large-Vessel Occlusion Stroke

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Reviewing Authors