A recent meta-analysis published in Neurology suggests that tenecteplase, a clot-busting drug, may be slightly more effective than alteplase in helping people recover from ischemic stroke. This type of stroke, the most common, is caused by a blockage that reduces blood flow to the brain.
Currently, alteplase is the only drug approved by the U.S. Food and Drug Administration (FDA) for treating ischemic stroke. Tenecteplase, while approved for use in treating ischemic stroke in Europe, is not yet FDA-approved for this purpose in the U.S.
However, it is sometimes used off-label for stroke treatment at specialized centers in the U.S. The drug is FDA-approved for treating clots in the coronary arteries.
In this new study, led by Dr. Georgios Tsivgoulis from the National and Kapodistrian University of Athens, researchers analyzed data from 11 studies that compared the effects of tenecteplase and alteplase on stroke recovery.
The analysis included nearly 7,500 patients, with about half treated with tenecteplase and the other half treated with alteplase. All patients received the medication within four-and-a-half hours after their stroke.
The results showed that while both drugs helped improve the chances of recovery, tenecteplase had a slight edge. Patients treated with tenecteplase were 5% more likely to make an excellent recovery three months after their stroke.
An excellent recovery was defined as having no symptoms or only very minor symptoms with no significant disability.
Additionally, tenecteplase was linked to a 10% higher likelihood of reducing disability, meaning that patients were more likely to regain the ability to carry out daily tasks on their own.
The chances of achieving a good recovery—a situation where patients experience slight disability but can still manage their daily lives without help—were similar between the two drugs.
“Both drugs are safe and increase the chances of a good recovery after stroke,” said Dr. Tsivgoulis. “But our findings suggest that tenecteplase might offer a greater chance of excellent recovery and reduced disability compared to alteplase.”
This meta-analysis offers support for considering tenecteplase as a better option when treating ischemic stroke. However, a limitation of the study is that not all of the clinical trials included have been published in peer-reviewed journals, as three of the 11 studies were only presented at scientific conferences.
More research is needed to further validate these findings and explore the long-term effects of tenecteplase.
Despite this, the study represents a promising step toward improving outcomes for stroke patients and provides valuable insights into the potential benefits of tenecteplase over alteplase.
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The research findings can be found in Neurology.
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