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Journal Title: | Tenecteplase use in the management of acute ischemic stroke: Literature review and clinical considerations |
Authors: | Hailu, Kirubel Cannon, Chad Hayes, Sarah |
Keywords: | Brain Ischemia Fibrinolytic Agents Humans Ischemic Stroke Stroke Tenecteplase Tissue Plasminogen Activator Treatment Outcome Alteplase Fibronlytics Pharmacotherapy Tenecteplase Thrombolytics |
Issue Date: | Jun-2022 |
Date Accessioned: | 2023-04-24T02:44:20Z |
Date Available: | 2023-04-24T02:44:20Z |
Accession Number: | 35020806 |
Url: | https://www.ncbi.nlm.nih.gov/pubmed/35020806 |
Description Affiliation: | Department of Pharmacy, Ascension St. Vincent's Riverside, Jacksonville, FL, USA. |
Format Startpage: | 944-949 |
Source Volume: | 79 |
Issue Number: | 12 |
Database: | Medline |
Notes: | eng Review England 2022/01/13 |
DOI: | 10.1093/ajhp/zxac010 |
Date: | Jun 7 NLM 2022 |
Abstract: | PURPOSE: Several research articles have been published within the last decade comparing the use of tenecteplase to alteplase in ischemic stroke management. Prior reporting on the comparative therapeutic efficacy and safety profiles of tenecteplase and alteplase is reviewed. SUMMARY: Tenecteplase is a variant of native tissue-type plasminogen activator, which rapidly promotes thrombolysis by catalyzing formation of the serine protease plasmin. Tenecteplase has theoretical advantages over alteplase as it has greater fibrin specificity and has a longer half-life than alteplase. This allows the administration of a single bolus over 5 to 10 seconds, as opposed to a bolus followed by a 1-hour infusion with alteplase. While currently approved by the Food and Drug Administration for the treatment of ST-segment elevation myocardial infarction, tenecteplase has also been studied in the treatment of acute ischemic stroke and has extensive data for this off-label indication. The most comprehensive trials to date evaluating the use of tenecteplase in acute ischemic stroke include the TNK-S2B, Australian TNK, ATTEST, Nor-Test, and EXTEND-IA TNK trials. Findings from these randomized controlled studies suggest that tenecteplase is at least as efficacious as alteplase in terms of neurological outcomes. The majority of these studies also reported a trend toward improved safety profiles with the use of tenecteplase. CONCLUSION: Current clinical evidence shows that tenecteplase is not inferior to alteplase for the treatment of ischemic stroke and suggests that tenecteplase may have a superior safety profile. Furthermore, tenecteplase also has practical advantages in terms of its administration. This can potentially lead to a decrease in medication errors and improvement in door to thrombolytic time. |
URI: | https://repository.southwesthealthcare.com.au/swhealthcarejspui/handle/1/3845 |
Journal Title: | American Journal of Health-System Pharmacy |
Type: | Journal Article |
Appears in Collections: | SWH Data Contributions |
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