REBEL EM - February 15, 2021 - By Salim Rezaie
Paper: Oliveira M et al. Tenecteplase for Thrombolysis in Stroke Patients: Systematic Review With Meta-Analysis. AJEM 2021. [Link is HERE]
"Clinical Question: What is the efficacy/safety of tenecteplase vs alteplase in the treatment of acute ischemic stroke?
Author Conclusion: “Tenecteplase is an alternative to alteplase for stroke thrombolysis, with lower cost and a more favourable pharmacokinetic profile.”
Clinical Take Home Point: Tenecteplase appears to be a reasonable alternative to alteplase with a similar safety profile but with the added benefits of helping improve early neurologic improvement and recanalization (surrogates of neurologic outcomes). The 0.2 to 0.25mg/kg dose of Tenecteplase in particular appeared to have the highest early neurological improvement rates and a trend for better functional outcomes at 3 months, however this latter outcome was not statistically significant."