Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence.

Abstract

INTRODUCTION:

Acute ischemic stroke is a leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA.

OBJECTIVE:

This review evaluates literature and utility of tenecteplase for treatment of acute ischemic stroke.

DISCUSSION:

Tenecteplase is modified, third generation fibrinolytic with greater specificity for fibrin bound clots. Current data in acute myocardial infarction suggest decreased bleeding events compared to alteplase. Multiple trials have investigated superiority of tenecteplase compared to tPA for treatment of acute ischemic stroke. Current guidelines designate tenecteplase as an alternative treatment for mild acute ischemic stroke patients based on recent literature.

CONCLUSION:

Recent emerging literature and limited recommendation guidance from governing medical societies leave many emergency medicine providers to weigh benefit versus risk of fibrinolytic therapy and tenecteplase's place in therapy. This review evaluates the available literature regarding tenecteplase and its utility in the treatment of acute ischemic stroke patients.

• Authors: Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 37 Issue 2 Pg. 344-348 (02 2019) ISSN: 1532-8171 [Electronic] United States
• PMID: 30471930 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator
• Tenecteplase

Topics

• Brain Ischemia (drug therapy)
• Fibrinolytic Agents (therapeutic use)
• Humans
• Injections, Intravenous
• Myocardial Infarction (drug therapy)
• Randomized Controlled Trials as Topic
• Stroke (drug therapy)
• Tenecteplase (administration & dosage, therapeutic use)
• Tissue Plasminogen Activator (therapeutic use)
• Treatment Outcome