Tenecteplase Is Reasonable Alternative to Alteplase for Ischemic Stroke

MONDAY, March 24, 2025 (HealthDay News) — For patients with ischemic stroke, tenecteplase seems to be a reasonable alternative to alteplase in terms of effectiveness and safety outcomes, according to a study published online March 12 in JAMA Network Open.

Justin F. Rousseau, M.D., from the University of Texas Southwestern Medical Center, and colleagues compared short-term effectiveness and safety outcomes for patients with ischemic stroke treated with intravenous tenecteplase versus alteplase in a comparative effectiveness study using data collected from July 1, 2020, through June 30, 2022. The primary end point was functional independence on discharge.

Data were included for 79,550 patients treated with intravenous thrombolysis, of whom 11.9 and 88.1 percent received tenecteplase and alteplase, respectively. The researchers observed no significant differences between tenecteplase and alteplase in terms of effectiveness or safety outcomes for the overall cohort after adjustment for covariates, including functional independence at discharge, symptomatic intracranial hemorrhage, and in-hospital mortality or hospice discharge. Among patients who were eligible for but did not undergo endovascular thrombectomy, significant improvement with tenecteplase was seen in discharge home, in-hospital mortality, and composite in-hospital mortality or hospice discharge.

“As the adoption of tenecteplase increases across stroke center types, geographic regions, and stroke characteristics, future research will provide additional insight into whether small but clinically important differences in outcomes between tenecteplase and alteplase exist,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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