ASA: Less Bleeding Seen With Tenecteplase for Ischemic Stroke

FRIDAY, Feb. 4, 2022 (HealthDay News) — For patients with ischemic stroke, use of tenecteplase (TNK) for thrombolysis is associated with a lower rate of symptomatic intracranial hemorrhage (sICH) than alteplase (ALT), according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

Steven J. Warach, M.D., Ph.D., from Ascension Healthcare and the University of Texas at Austin, and colleagues compared rates of sICH in patients with ischemic stroke treated with TNK or ALT using data from a multicenter international registry. Data were included for 7,891 patients from hospitals in New Zealand, Australia, and the United States.

Patients receiving TNK were older, more often male, had higher National Institutes of Health Stroke Scale scores, and underwent mechanical thrombectomy more often. The researchers found that the sICH rate was 3.71 and 2.13 percent for ALT and TNK, respectively (adjusted odds ratio, 0.49; 95 percent confidence interval, 0.31 to 0.76; P = 0.002). For patients not undergoing thrombectomy, the rate of sICH was 3.00 and 1.74 percent for ALT and TNK, respectively (adjusted odds ratio, 0.48; 95 percent confidence interval, 0.27 to 0.87; P = 0.016). The rate of sICH was 6.80 and 2.80 for ALT and TNK, respectively, for thrombectomy-treated cases (adjusted odds ratio, 0.60; 95 percent confidence interval, 0.31 to 1.16; P = 0.129).

“The significantly lower rates of sICH surprised us,” Warach said in a statement. “Our finding that tenecteplase had about half the risk of sICH when compared with alteplase in routine clinical practice provides reassurance that tenecteplase does not result in harmful bleeding when used routinely for stroke treatment.”

Several authors disclosed financial ties to pharmaceutical companies, including Genentech, which manufactures tenecteplase.

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