Evidence map›Paper›PMID 36746381›Full record

ReviewJournal of stroke2023

Replacing Alteplase with Tenecteplase: Is the Time Ripe?

Nishita Singh, Bijoy K Menon, Adam A Dmytriw, Robert W Regenhardt, Joshua A Hirsch, Aravind Ganesh

Open access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Head-to-Head: Recombinant Human Prourokinase Versus Intravenous Thrombolytics in Acute Ischemic Stroke Within 4.5 Hours - A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
  9. Grand challenges in pediatric stroke.Frontiers in stroke · 2023
    Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Nishita SinghCalgary Stroke Program, Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, and the Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Bijoy K MenonCalgary Stroke Program, Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, and the Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Adam A DmytriwDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Joshua A HirschDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Aravind GaneshCalgary Stroke Program, Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, and the Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Harvard University · USUniversity of Calgary · CAManitoba Health · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Thrombolysis for acute ischemic stroke has predominantly been with alteplase for over a quarter of a century. In recent years, with trials showing evidence of higher rates of successful reperfusion, similar safety profile and efficacy of tenecteplase (TNK) as compared to alteplase, TNK has now emerged as another potential choice for thrombolysis in acute ischemic stroke. In this review, we will focus on these recent advances, aiming: (1) to provide a brief overview of thrombolysis in stroke; (2) to provide comparisons between alteplase and TNK for clinical, imaging, and safety outcomes; (3) to focus on key subgroups of interest to understand if there is an advantage of using TNK over alteplase or vice-versa, to review available evidence on role of TNK in intra-arterial thrombolysis, as bridging therapy and in mobile stroke units; and (4) to summarize what to expect in the near future from recently completed trials and propose areas for future research on this evolving topic. We present compelling data from several trials regarding the safety and efficacy of TNK in acute ischemic stroke along with completed yet unpublished trials that will help provide insight into these unanswered questions.

Indexed as

Acute ischemic strokeAlteplaseTenecteplaseThrombolysis

Identifiers

PMID36746381
PMCPMC9911848
OpenAlexW4319332861

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.