Clinical outcomes and safety profile of Tenecteplase in wake-up stroke

Acta Neurologica Scandinavica
Hassan Khan AhmedMartin Wilhelm Kurz

Abstract

Tenecteplase has probably pharmacological and clinical advantages in the treatment of acute ischemic stroke. There are lacking data about safety and efficacy of tenecteplase in wake-up stroke (WUPS). To investigate safety and efficacy of tenecteplase compared to alteplase in WUPS patients included in NOR-TEST. WUPS patients in NOR-TEST were included in the study based on DWI-FLAIR mismatch. Included patients randomly assigned (1:1) to receive intravenous tenecteplase 0.4 mg/kg (to a maximum of 40 mg) or alteplase 0.9 mg/kg (to a maximum of 90 mg). Neurological improvement was defined as 1) favorable functional outcome at 90 days modified Rankin Scale (mRS) of 0 or 1 and 2) neurological improvement measured with the National Institutes of Health Stroke Scale (NIHSS) of 4 points within 24 hours as compared to admission NIHSS or NIHSS 0 at 24 hours. Of 1100 patients from 13 stroke centers included in NOR-TEST, 45 were WUPS patients. Of these, 5 patients were stroke mimics and excluded. Of the remaining 40 patients (3.6%), 24 were treated with alteplase (60%). There was no difference in the number of patients achieving a good clinical outcome (mRS 0-1) in either treatment group. Patients treated with tenecteplase showed a better ea...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Sep 26, 2008·The New England Journal of Medicine·Werner HackeUNKNOWN ECASS Investigators
Mar 23, 2012·The New England Journal of Medicine·Mark ParsonsChristopher Levi
Mar 15, 2014·Stroke; a Journal of Cerebral Circulation·Atte MeretojaLeonid Churilov
Apr 19, 2015·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Audun OdlandKathinka D Kurz
Jun 9, 2016·Annals of Neurology·Andrew D BarretoUNKNOWN Wake-Up Stroke Investigators
Sep 20, 2016·Acta Neurologica Scandinavica·M W KurzK D Kurz
May 8, 2018·Acta neurologica Belgica·A ThelenganaKameshwar Prasad
May 17, 2018·The New England Journal of Medicine·Götz ThomallaUNKNOWN WAKE-UP Investigators
Feb 23, 2020·JAMA : the Journal of the American Medical Association·Bruce C V CampbellUNKNOWN EXTEND-IA TNK Part 2 investigators

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Citations

Oct 14, 2020·Stroke; a Journal of Cerebral Circulation·Steven J WarachTruman J Milling

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