ASA: IV Tenecteplase Beneficial at 4.5 to 24 Hours After Non-Large Vessel Occlusion Ischemic Stroke

TUESDAY, Feb. 10, 2026 (HealthDay News) — For patients with non-large vessel occlusion acute ischemic stroke and salvageable brain tissue, intravenous tenecteplase administered 4.5 to 24 hours after stroke onset is associated with a higher likelihood of excellent functional outcome at 90 days, according to a study published online Feb. 5 in the Journal of the American Medical Association to coincide with the annual American Stroke Association International Stroke Conference, held from Feb. 4 to 6 in New Orleans.

Gaoting Ma, M.D., from the Xuanwu Hospital Capital Medical University in Beijing, and colleagues examined the efficacy and safety of intravenous tenecteplase administered 4.5 to 24 hours after stroke onset in 566 patients with non-large vessel occlusion and potentially salvageable brain tissue (determined on perfusion imaging). Participants were randomly assigned to receive intravenous tenecteplase or standard medical treatment (282 and 284 individuals, respectively). The primary efficacy outcome was an excellent functional outcome, defined as a modified Rankin Scale score of 0 or 1 at 90 days.

The researchers found that an excellent functional outcome occurred in 43.6 and 34.2 percent of patients in the tenecteplase and control groups, respectively (risk ratio, 1.28; 95 percent confidence interval, 1.04 to 1.57; P = 0.02). The incidence of symptomatic intracranial hemorrhage was 2.8 and 0 percent with tenecteplase and standard medical treatment, respectively (risk difference, 2.85 percent). Ninety-day mortality was 5.0 and 3.2 percent with tenecteplase and standard medical treatment, respectively (risk ratio, 1.57; 95 percent confidence interval, 0.69 to 3.57; P = 0.28).

“These results support extending the thrombolysis time window in this patient population,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry; the study was partially funded by the China Shijiazhuang Pharmaceutical Company Recomgen Pharmaceutical (Guangzhou) Co LTD., which provided the study drug.

Abstract/Full Text

More Information