If patients with clot-caused strokes obtain medical care more than 4½ hours after their symptoms are noticed, it is too late to receive the standard clot-busting medication alteplase.
In a new study, researchers found drug tenecteplase appears to lengthen the window for additional stroke treatment to up to 24 hours.
A one-hour infusion of alteplase is the standard treatment for a clot-caused (ischemic) stroke, administered within 4.5 hours of first stroke symptoms.
Alteplase dissolves blood clots that are blocking arteries supplying oxygen-rich blood to the lungs or brain and has been FDA-approved for the immediate treatment of ischemic stroke since 1996.
A newer medication, tenecteplase, is also a clot-busting medication and is a bioengineered variant of alteplase, and there are ongoing studies to determine its safety, efficacy and treatment parameters for ischemic stroke.
Previous studies of the drug found it may be non-inferior to alteplase and may be superior for treating large-vessel strokes.
In the study, the team tested 86 patients with ischemic strokes. The patients had brain imaging between 4.5 and 24 hours after they were last known to be free of stroke symptoms.
On imaging, all study participants were found to have large, affected brain areas.
Study participants were randomly assigned to two groups: 43 patients (average age of 68 years; 58.1% male) received a lower (0.25 mg/kg) dose of tenecteplase; and
43 patients (average age of 67 years; 72.1% male) received a higher (0.32 mg/kg) dose of tenecteplase.
The researchers found at the lower dose of tenecteplase, 14 of 43 patients (32.6%) achieved a positive health outcome.
At the higher dose of tenecteplase, 10 of 43 patients (23.3%) achieved the designated positive outcome criteria.
Among all study participants evaluated 3 months after treatment, more than half (53.5%) of the patients were no more than slightly disabled, not able to carry out all previous activities but did not require daily assistance.
About 38% of the participants either had no big symptoms of residual neurological deficits or had mild symptoms but were able to return to pre-stroke activities of daily living.
The team says tenecteplase appears to be safe and potent in reestablishing blood flow through blocked, large brain vessels, thereby preventing damage to brain tissue at risk of dying.
It seems feasible that with tenecteplase doctors may be able to extend the time window for treatment to 24 hours after the time the patient was last known to be well.
If you care about stroke, please read studies about new way to prevent recurrent stroke, and diet that may reduce your stroke risk by 10%.
For more information about stroke, please see recent studies about how to repair damaged brain after stroke, and results showing these 3 common prescribed drugs may increase stroke risk by 60%.
The study was presented at the American Stroke Association’s International Stroke Conference and was conducted by Xin Cheng et al.
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