- Among patients with predominantly mild stroke, tenecteplase (TNKase) was at least as efficacious and safe as alteplase (Activase, others) when administered within 3-4.5 hours of symptom onset.
Why this matters
- Data from early-phase trial suggest tenecteplase has better thrombolytic profile and potency.
- Median admission National Institutes of Health Stroke Scale score: 3.
- Good functional outcome at 3 months in intention-to-treat analysis:
- 57% with tenecteplase vs 53% with alteplase;
- OR, 1.19 (95% CI, 0.68-2.10).
- Findings same after excluding patients with stroke mimics or with modified Rankin scale score >1 before stroke:
- 61% vs 57%;
- OR, 1.24 (95% CI, 0.65-2.37).
- Intracranial hemorrhage in first 48 hours:
- 5.7% vs 6.7%;
- OR, 0.84 (95% CI, 0.26-2.70).
- Mortality at 3 months:
- 5.7% vs 4.5%;
- OR, 1.19 (95% CI, 0.35-4.71).
- Prespecified substudy of 194 patients from phase 3 randomized controlled trial comparing tenecteplase with alteplase (Norwegian Tenecteplase Stroke Trial, NOR-TEST).
- Main outcomes: good functional outcome (modified Rankin scale score, 0 or 1), intracranial hemorrhage, mortality.
- Funding: Research Council of Norway.
- Generalizability to more severe stroke unknown.
- Rates of intracranial hemorrhage, mortality lower than expected.