Evidence map›Paper›PMID 41572186›Full record

ArticleBMC neurology2026

Comparative effectiveness of Tenecteplase and Alteplase for ischemic stroke: real-world data from a stroke center.

Toska Maxhuni, Francesca Culaj, Merve-Melis Sayar, Priyanka Böttger, Samra Hamzic, Stefan T Gerner, Tobias Braun, Maxime Viard, Martin Juenemann, Heidrun H Krämer and 1 more

Abstract readComparative Study
In one paragraph

Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

11 authors.

Toska Maxhuni *Department of Neurology, Justus-Liebig-University, Giessen, Germany. toska.maxhuni@neuro.med.uni-giessen.de.ORCID http://orcid.org/0009-0001-5448-1992
Francesca Culaj *Department of Neurology, Justus-Liebig-University, Giessen, Germany.
Merve-Melis SayarDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Priyanka BöttgerDepartment of Cardiology, Angiology and Critical Care Medicine, Justus Liebig University, Giessen, Germany.
Samra HamzicDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Stefan T GernerDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Tobias BraunDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Maxime ViardDepartment of Neurology, Kantonsspital Winterthur, Winterthur, 8401, Switzerland.
Martin JuenemannDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Heidrun H KrämerDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.
Omar AlHaj OmarDepartment of Neurology, Justus-Liebig-University, Giessen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTenecteplase (TNK) and Alteplase (rt-PA) are intravenous thrombolytics used in acute ischemic stroke (AIS). While Alteplase has long been the standard of care, TNK is now also approved for AIS by both the EMA and FDA. Its single-bolus administration and favorable pharmacokinetics offer practical advantages. Despite growing guideline support, real-world data comparing both agents remain limited. This study aimed to compare clinical characteristics, imaging findings, treatment outcomes, and complication rates of AIS patients treated with TNK versus Alteplase at a single stroke center.

methodsWe conducted a retrospective monocentric analysis of 101 AIS patients treated with TNK (n = 39) or Alteplase (n = 62). We compared demographics, vascular risk factors, imaging findings, reperfusion therapies, and clinical outcomes using independent samples t-tests, Chi-square, and Mann–Whitney U-tests as appropriate.

resultsBaseline characteristics were comparable between groups, including age (TNK: 72.7 ± 14.4 vs. Alteplase: 70.1 ± 14.3), sex, and pre-stroke mRS. Initial NIHSS scores were similar (TNK: 6.0 ± 6.3 vs. Alteplase: 7.2 ± 8.2, p = 0.83). No significant differences were found in LVO rates (15.4% vs. 27.4%, p = 0.16), perfusion delay, or infarct demarcation. Functional outcomes at discharge (mRS: 2.3 ± 1.8 vs. 2.0 ± 1.9, p = 0.39) and rates of symptomatic intracranial hemorrhage (11.1% vs. 10.3%, p = 0.91) were similar.

conclusionThis real-world study found that TNK and alteplase had similar early clinical and safety outcomes during the initial implementation of TNK. These observational findings generate hypotheses and support the need for larger prospective studies to assess long-term outcomes and reduce confounding factors related to the transition.

Indexed as

Fibrinolytic AgentsIschemic StrokeStrokeTenecteplaseTissue Plasminogen ActivatorAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeFibrinolytic AgentsTenecteplaseTissue Plasminogen ActivatorAcute ischemic strokeAlteplaseDoor-to-needle timeIntravenous thrombolysisTenecteplase

Identifiers

PMID41572186
PMCPMC12853838

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LicenceCC BY-NC-ND
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Registered trials

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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.