Study supports thrombolysis with tenecteplase in patients with ischemic stroke
USA: Stroke thrombolysis with tenecteplase is associated with lower odds of symptomatic intracranial haemorrhage (sICH) than treatment with alteplase, findings from CERTAIN registry data have revealed in a large study.
The results, published in JAMA Neurology, support the safety of tenecteplase for stroke thrombolysis in real-world clinical practice.
Symptomatic intracranial haemorrhage is a severe complication of stroke thrombolytic therapy. Many stroke centres have adopted 0.25-mg/kg tenecteplase over alteplase for stroke thrombolysis based on evidence from randomized comparisons to alteplase and its practical advantages. No significant differences in sICH were reported from randomized clinical trials or published case series for the 0.25-mg/Kg dose.
Against the above background, Steven J. Warach, University of Texas at Austin, Austin, and colleagues aimed to evaluate sICH risk following ischemic stroke in patients treated with tenecteplase compared to those treated with alteplase in a retrospective observational study. They hypothesized that tenecteplase thrombolysis would be associated with a reduced sICH risk.
For this purpose, the authors used data from the extensive multicenter international CERTAIN collaboration containing de-identified data on ischemic stroke patients treated with IV thrombolysis. The analysis included data from more than 100 US, Australian, and New Zealand hospitals that used tenecteplase or alteplase for patients treated between 2018 and 2021. The retrospective analysis included all 9238 patients (median age was 71 years, and 48% were female) who received thrombolysis. Patients with acute ischemic stroke who were considered eligible and received thrombolysis were included.
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