Different doses of tenecteplase vs alteplase in thrombolysis therapy of acute ischemic stroke: evidence from randomized controlled trials

Drug Design, Development and Therapy
Na XuZhong Wang

Abstract

Recent studies showed inconsistent results of tenecteplase vs alteplase for acute ischemic stroke (AIS) with safety and efficacy. A meta-analysis was performed to explore the value of tenecteplase and alteplase in AIS treatment. Medline, Embase, and Cochrane Library from January 2001 to April 2018 were searched for randomized controlled trials (RCTs) with tenecteplase vs alteplase for AIS. The primary outcomes were early neurological improvement at 24 h and functional outcome at 3 months. We pooled 1,390 patients from four RCTs. Tenecteplase showed a significant early neurological improvement (P=0.035) compared with alteplase. In addition, tenecteplase showed a neutral effect on excellent outcome (P=0.309), good functional outcome (P=0.275), and recanalization (P=0.3). No significant differences in safety outcomes were demonstrated. In subgroup analysis, 0.25 mg/kg dose of tenecteplase showed a significantly increased early neurological improvement (P<0.001). In serious stroke at baseline (National Institutes of Health Stroke Scale [NIHSS] >12) subgroup, tenecteplase showed a dramatic early neurological improvement (P=0.002) and low risks of any intracranial hemorrhage (ICH) (P=0.027). Tenecteplase provided better early neurolo...Continue Reading

Citations

Feb 5, 2019·Expert Opinion on Drug Safety·Katleen Wyatt ChesterGeorge M Dillon
Jul 19, 2019·Stroke; a Journal of Cerebral Circulation·Adrian M Burgos, Jeffrey L Saver
Jun 20, 2020·F1000Research·Nicholas Liaw, David Liebeskind
Dec 12, 2019·Current Treatment Options in Cardiovascular Medicine·Julian MaingardThabele M Leslie-Mazwi
Jul 31, 2019·Computational and Structural Biotechnology Journal·Jan MicanJiri Damborsky

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