Making the Switch from Alteplase to Tenecteplase? Researchers Compare Mortality Rates of Stroke Treatments

Researchers at the University of Texas Medical Branch recently compared the two treatments for acute stroke and found that one type of treatment has a lower mortality rate.

“In this large multicenter study, Tenecteplase for the treatment of acute stroke demonstrated a lower mortality rate, decreased intracranial hemorrhage, and less significant blood loss,”  said Dr. Luke Murphy, Assistant Professor at the Department of Emergency Medicine at UTMB and lead author of the study.

People with stroke are typically treated with two widely used a clot-busting drugs aiming at returning the blood supply to their brain. The medicine itself is either Alteplase, or Tenecteplase, a genetically modified variant of alteplase. Researchers at UTMB recently compared the two treatments by mortality rates and the frequency of hemorrhaging from patients at over 50 institutions. The results were published this week in the Annals of Emergency Medicine.

The study identified 3,432 patients treated with Tenecteplase and 55,894 patients treated with Alteplase for stroke since 2012. These patients are from 54 academic medical centers/health care organizations in the US. Researchers analyzed mortality rates, the frequency of intracranial hemorrhage, and blood transfusions (as a marker of significant blood loss) that were recorded for each group over the ensuing 7- and 30-day periods. Patients treated with Tenecteplase had a significantly lower mortality rate and lower risk of major bleeding than Alteplase at 30 days after the drugs were administered for stroke, according to the research findings.

“Tenecteplase has a higher fibrin specificity and longer half-life than alteplase, providing the convenience of single bolus administration,” said Dr. Dietrich Jehle, Chair of Department of Emergency Medicine at UTMB and co author on the study. “Bolus dosing may allow patients to get the blood clot or thrombus removed earlier with shorter times for vessel opening that could reduce potential risks.