ESOC 2022 | New data supports use of tenecteplase versus alteplase
Aristeidis Katsanos, MD, McMaster University, Hamilton, Ontario, Canada, comments on one of the major topics discussed at the European Stroke Organisation Conference 2022: alteplase versus tenecteplase for intravenous thrombolysis in acute ischemic stroke. Dr Katsanos presented data from an analysis of the SITS International Stroke Thrombolysis Registry, which compared tenecteplase and alteplase in patients with acute ischemic stroke within 4.5 hours from symptom onset, using propensity score matching. Patients who received tenecteplase showed a lower rate of mortality, with no significant difference in symptomatic intercranial hemorrhage occurrence. The AcT randomized, controlled trial (NCT03889249) also looked at alteplase compared to tenecteplase in patients with acute ischemic stroke, findings tenecteplase to be non-inferior. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.
Transcript (edited for clarity)
Yeah, that’s a very interesting topic, and there were many trials presented from great colleagues and investigators. What we did is that we were able to analyze data from the SITS registry. SITS is an international registry, so we’re able to take a closer look to this registry and analyze observational data from patients that they were receiving tenecteplase and some other that were receiving alteplase...
Yeah, that’s a very interesting topic, and there were many trials presented from great colleagues and investigators. What we did is that we were able to analyze data from the SITS registry. SITS is an international registry, so we’re able to take a closer look to this registry and analyze observational data from patients that they were receiving tenecteplase and some other that were receiving alteplase.
So we’re able to match those ones that they got tenecteplase to the ones that they got alteplase and compare their outcomes. That was the study. We found some interesting findings. First of all, we found that patients that got tenecteplase, they did better than the ones that got alteplase, lower mortality rates and no different in the bleeding risks in the brain. And we are talking about symptomatic intracranial hemorrhage, so the risk of bleeding in the brain to be associated also with a neurological decline. And that was really interesting to see in this dataset.
I can tell you also about the AcT study. I’m based in Canada, so I was happy to participate in the AcT study. So AcT study proved the non-inferiority of tenecteplase compared to alteplase. It was a very pragmatic randomized clinical trial. So I think now going back home, we need to digest the results of the AcT trial and also the other trials presented. And I’m hoping that will change our clinical practice and consider using tenecteplase as an alternative to alteplase, at least for patients with a large vessel occlusion. I think it’s reasonable. We have the evidence now.
Read more...
