Transition to newer clot-busting drug improves patient outcomes and lowers treatment cost

A newer-generation clot-busting drug called Tenecteplase outperforms the traditional treatment for ischemic strokes in several key areas, including better health outcomes and lower costs, according to a new study published  in the American Stroke Association's journal Stroke.

Nearly 800,000 people in the United States have a stroke every year. The vast majority of those strokes (about 87%) are ischemic, meaning they occur when a vessel supplying blood to the brain is obstructed by a blood clot. This can result in a corresponding loss of neurologic function.

Both Tenecteplase and alteplase are federally approved for use in dissolving clots in blocked heart arteries. But the newer drug Tenecteplase is also being used by clinicians, off-label, to treat ischemic strokes, because clinical trials in stroke suggest that it may be at least as good as alteplase and it is easier to administer. Tenecteplase is administered by a single 5 to 10 second intravenous injection. The researchers compared its performance with the standard drug for stroke, alteplase, which is injected over 60 minutes.

For patients who come into the emergency department after a stroke, the study found that the "door-to-needle" time — the time between patients' arrival and the moment they receive treatment — was on average six minutes quicker with Tenecteplase. And for patients who also required a thrombectomy, the surgical removal of a blood clot causing the stroke, Tenecteplase sped up the process of transferring the patient to a thrombectomy-capable stroke center by 25 minutes.

Researchers also saw improvements in clinical outcomes for patients given Tenecteplase, including:

A 5% increase in patients who were able to walk independently at time of hospital discharge to home.

A 4% decrease in occurrences of bad events such as brain hemorrhages, discharge to hospice care or death.

The third major improvement: cost. The research team found that Tenecteplase treatment cost the hospitals about $2,500 less than alteplase per patient.

Reference:

Steven Warach et al,Tenecteplase As Stroke Thrombolytic in Practice,Stroke