Annals of Indian Academy of Neurology (May 2024)

Comparative Analysis of Tenecteplase versus Alteplase in Acute Ischemic Stroke: A Multicentric Observational Study from Eastern India

  • Arpan Dutta,
  • Subhadeep Gupta,
  • Uddalak Chakraborty,
  • Chayan Mondal,
  • Soumozit Banerjee,
  • Deep Das,
  • Sanat K. Jatua,
  • Susanta Chakrabarty,
  • Samiran Misra,
  • Jishnu Bhattacharya,
  • Samir K. Datta,
  • Somnath Ghosh,
  • Debasish Sanyal,
  • Arnab Sarkar,
  • Biman K. Ray

DOI
https://doi.org/10.4103/aian.aian_59_24
Journal volume & issue
Vol. 27, no. 3
pp. 269 – 273

Abstract

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Background: Tenecteplase is used as an alternative to alteplase and is considered noninferior for thrombolysis in acute ischemic stroke. Objectives: To compare the effectiveness and adverse effects of tenecteplase and alteplase in the real-world management of acute ischemic stroke. Materials and Methods: In this retrospective observational study, we collected data from acute ischemic stroke patients admitted in six hospitals in West Bengal, India, and were thrombolysed with tenecteplase or alteplase between July 2021 and June 2022. Demographic data, baseline parameters, hospital course, and 3-month follow-up data were collected. The percentage of patients achieving a score of 0–2 in the modified Ranking scale at 3 months, rate of symptomatic intracranial hemorrhage, and all-cause mortality within 3 months were the main parameters of comparison between the two thrombolytic agents. Results: A total of 162 patients were initially included in this study. Eight patients were excluded due to unavailability of follow-up data. Among the remaining patients, 71 patients received tenecteplase and 83 patients received alteplase. There was no statistically significant difference between tenecteplase and alteplase with respect to the percentage of patients achieving functional independence (modified Rankin scale score 0–2) at 3 months (53.5% vs. 60.2%, P = 0.706), rate of symptomatic intracranial hemorrhage (5.6% vs. 10.8%, P = 0.246), and all-cause mortality at 3 months (11.3% vs. 15.7%, P = 0.628). Conclusion: The effectiveness of tenecteplase is comparable to alteplase in the real-world management of acute ischemic stroke. Symptomatic intracranial hemorrhage and all-cause mortality rates are also similar in real-world practice.

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