ISC 2023 | Who will benefit the most from tenecteplase for intravenous thrombolysis?

Shuya Li, MD, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, shares her thoughts on the current evidence supporting the use of tenecteplase over alteplase for intravenous thrombolysis (IVT) in acute ischemic stroke. The recently reported TRACE II trial showed that tenecteplase was non-inferior to alteplase in over 1400 patients with ischemic stroke, with regards to the rate of excellent functional outcome (mRS 0-1) at 90 days. While TRACE II enrolled only participants who were ineligible for/denied endovascular thrombectomy (EVT), other trials have assessed the value of tenecteplase for bridging therapy, finding that it is non-inferior to alteplase. Subgroup analyses in TRACE II did not uncover any surprising outcomes. Current evidence is limited but identifying which patients are most likely to benefit from tenecteplase use of the subject of several ongoing trials. This interview took place during the International Stroke Conference (ISC) 2023 in Dallas, TX.

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