New clot-busting stroke drug lowers risk of serious complications
Tenecteplase, a single-injection medication prescribed for treating blood clots, is associated with fewer serious complications than alteplase, according to new data to be presented at the American Stroke Association’s International Stoke Conference 2022.
Alteplase is currently seen as the standard of care for stroke treatment among many clinicians. It is administered by injection, followed by an hour-long infusion, while tenecteplase is administered by just a single injection. Alteplase and tenecteplase are both cleared for dissolving clots in blocked heart arteries and tenecteplase is sometimes used off-label to treat ischemic strokes.
The researchers analyzed data from 1,462 patients given tenecteplase and 6,429 patients given alteplase. All patients were treated from July 2018 to June 2021 in New Zealand, Australia or the United States.
Among the tenecteplase group, 44.1% of patients were women and the median age was 73 years old. Among the alteplase group, 48% of patients were women and the median age was 70 years old.
Under its ischemic stroke treatment guidelines, the American Heart Association has said that tenecteplase may be appropriate for ischemic stroke in select patients.
While there have been a few recent clinical trials focused on ischemic stroke that have compared alteplase and tenecteplase, large, Phase 3 trials are being conducted.
In the analysis, the symptomatic intracranial hemorrhage (sICH) rate was 43% lower in patients who received tenecteplase (2.13% vs. 3.71%). Also, among patients who did not undergo thrombectomy, the sICH rate was 42% lower among those who received tenecteplase (1.74% vs. 3%).
Finally, among patients who required thrombectomy, the sICH rate was 59% lower for patients who received tenecteplase (2.8% vs. 6.8%).
“The significantly lower rates of sICH surprised us," lead author Steven J. Warach, MD, PhD, a professor of neurology at the Dell Medical School at the University of Texas at Austin, said in a prepared statement. "Our finding that tenecteplase had about half the risk of sICH when compared with alteplase in routine clinical practice provides reassurance that tenecteplase does not result in harmful bleeding when used routinely for stroke treatment."
The International Stroke Conference 2022 is scheduled to run from Feb. 8 to Feb. 11. More information is available here.