Efficacy and safety outcomes of Tenecteplase versus Alteplase for thrombolysis of acute ischemic stroke

A meta-analysis comparing Tenecteplase (TNK) and alteplase in acute ischemic stroke (AIS) treatment reveals that TNK 0.25 mg/kg is as effective and safe as alteplase 0.9 mg/kg within 4.5 hours of AIS onset. TNK demonstrated a statistically significant increase in early vessel recanalization and excellent recovery. No significant differences were found in good recovery, early neurological improvement, poor recovery, symptomatic intracerebral hemorrhage, PH2, or mortality. The network meta-analysis showed comparable efficacy and safety among TNK 0.1 mg/kg, TNK 0.25 mg/kg, TNK 0.32 mg/kg, TNK 0.4 mg/kg, and alteplase 0.9 mg/kg. TNK 0.25 mg/kg is a viable alternative to alteplase in AIS thrombolysis.