ArticleFrontiers in neurology2025
Comparative effectiveness and safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke: a retrospective study.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Pachymic Acid Targets PI3K/Akt Signaling Pathway to Attenuate tPA-Induced Hemorrhagic Transformation After Ischemic Stroke.CNS neuroscience & therapeutics · 2026Article
- Thrombus Composition and the Evolving Role of Tenecteplase in Acute Ischemic Stroke.Journal of clinical medicine · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Tenecteplase has been proposed as a practical alternative to alteplase for intravenous thrombolysis in acute ischemic stroke. Although randomised trials have demonstrated noninferiority, data from real-world comparative cohorts remain limited. Aim: This study evaluated functional and safety outcomes of tenecteplase compared with alteplase in a single-center cohort. Methods: We retrospectively analysed consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis with either tenecteplase or alteplase between April 2023 and April 2025. The primary endpoint was excellent functional recovery at 90 days, defined as a modified Rankin Scale (mRS) score of 0-1. Secondary endpoints included functional independence (mRS 0-2), early neurological improvement, and symptomatic intracranial hemorrhage (sICH). Multivariable logistic regression was used with adjustments for age, baseline NIHSS, diabetes, and atrial fibrillation. Subgroup analyses were performed by age, baseline stroke severity, and history of prior stroke. Results: A total of 226 patients were included, of whom 147 received alteplase and 79 received tenecteplase. Patients receiving alteplase were older (68 vs. 65) and more frequently had diabetes (49.0% vs. 34.2%) or atrial fibrillation (18.4% vs. 7.6%). At 90 days, good functional outcome (mRS 0-2) was achieved in 27.9% overall (31.6% tenecteplase vs. 26.0% alteplase) and excellent outcome (mRS 0-1) in 20.4% (22.2% vs. 19.3%). Early neurological improvement occurred in 35.8% (42.2% vs. 31.6%). Rates of sICH were low (6.1% vs. 2.5%) and not significantly different after adjustment (aOR 0.41, 95% CI 0.06-1.72). After multivariable adjustment, tenecteplase did not show a statistically significant association with excellent functional recovery (aOR 1.42, 95% CI 0.75-2.70; Conclusion: Tenecteplase demonstrated comparable safety and functional outcomes to alteplase, with signals of potential benefit in patients with more severe strokes. These findings reinforce trial evidence supporting tenecteplase as a practical and effective alternative to alteplase.
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