Article
Pharmacology & Pharmacy
Xuting Zhang, Wansi Zhong, Xiaodong Ma, Xiaoling Zhang, Hongfang Chen, Zhimin Wang, Min Lou, GIANT Investigators
Summary: The study aimed to investigate the impact of Ginkgolide(R) treatment on neurological function in patients receiving intravenous recombinant tissue plasminogen activator (rt-PA). Results showed that patients in the Ginkgolide(R) treatment group had better outcomes and lower rates of symptomatic intracerebral hemorrhage compared to the control group.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Clinical Neurology
Zekun Wang, Kangxiang Ji, Qi Fang
Summary: In the Asian population beyond the 4.5-hour time window, the effectiveness of low-dose alteplase is comparable to standard-dose alteplase, but may be less effective in patients aged 70 and older.
FRONTIERS IN NEUROLOGY
(2023)
Review
Clinical Neurology
Hassan Kobeissi, Sherief Ghozy, Bilal Turfe, Cem Bilgin, Ramanathan Kadirvel, David F. F. Kallmes, Waleed Brinjikji, Alejandro A. A. Rabinstein
Summary: Through a meta-analysis of randomized controlled trials (RCTs), we found that tenecteplase and alteplase have similar safety and efficacy for the treatment of acute ischemic stroke (AIS).
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Tobias D. Faizy, Michael Mlynash, Michael P. Marks, Soren Christensen, Reza Kabiri, Gabriella M. Kuraitis, Gabriel Broocks, Laurens Winkelmeier, Vincent Geest, Jawed Nawabi, Maarten G. Lansberg, Gregory W. Albers, Jens Fiehler, Max Wintermark, Jeremy J. Heit
Summary: The administration of tPA before endovascular thrombectomy (EVT) is associated with favorable venous outflow (VO) profiles, suggesting its potential to improve patients' venous drainage.
Article
Clinical Neurology
Marek Sykora, Stefan Krebs, Dominika Miksova, Ines Badic, Thomas Gattringer, Simon Fandler-Hoefler, Martha Marko, Stefan Greisenegger, Michael Knoflach, Wilfried Lang, Julia Ferrari
Summary: This study compares the early safety and efficacy of IVT with that of DAPT in the acute setting of mild ischemic stroke, and suggests that IVT may be associated with harm. Further research on the acute therapy of mild stroke is highly warranted.
Article
Health Care Sciences & Services
Angel Estella, Miriam Perez Ruiz, Juan Jose Serrano
Summary: This study aimed to compare the combined effect and safety of tenecteplase and alteplase in ischemic stroke patients. The results showed no significant differences in successful recanalization and functional outcome between the two drugs, but tenecteplase had worse neurological results after 24 hours.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Medicine, General & Internal
Heitor Cabral Frade, Susan E. Wilson, Anne Beckwith, William J. Powers
Summary: This study compared clinical outcomes of patients with acute ischemic stroke receiving initial CT alone versus additional MRI, and found that the strategy of initial CT alone was noninferior in terms of clinical outcomes at discharge and at 1 year. Further research is needed to determine the specific benefits of MRI for patients hospitalized with acute ischemic stroke.
Review
Clinical Neurology
Huo Liang, Xue Wang, Xuemei Quan, Shijian Chen, Bin Qin, Shuolin Liang, Qiuhui Huang, Jian Zhang, Zhijian Liang
Summary: This study compared the efficacy and safety of tenecteplase and alteplase for acute ischemic stroke. The results showed that both tenecteplase 0.25 mg/kg and alteplase 0.9 mg/kg were superior to placebo in improving functional outcomes. Moreover, tenecteplase 0.25 mg/kg outperformed alteplase 0.9 mg/kg in excellent functional outcome. Therefore, tenecteplase 0.25 mg/kg may be a better alternative to alteplase 0.9 mg/kg for acute ischemic stroke treatment.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Yu Zhou, Zijun Wang, Johanna Ospel, Mayank Goyal, Rosalie McDonough, Pengfei Yang, Yongwei Zhang, Lei Zhang, Xiaofei Ye, Fulai Wei, Dajing Su, Huawen Lu, Xianting Que, Hongxin Han, Tong Li, Jianmin Liu
Summary: This study aimed to investigate whether hyperglycemia affects the treatment effect of intravenous alteplase prior to thrombectomy in patients with large vessel occlusion stroke. The results showed that combination therapy improved clinical outcomes in patients without hyperglycemia, while thrombectomy alone may be preferred in hyperglycemic patients.
Article
Medicine, General & Internal
Wenjie Zi, Zhongming Qiu, Fengli Li, Hongfei Sang, Deping Wu, Weidong Luo, Shuai Liu, Junjie Yuan, Jiaxing Song, Zhonghua Shi, Wenguo Huang, Min Zhang, Wenhua Liu, Zhangbao Guo, Tao Qiu, Qiang Shi, Peiyang Zhou, Li Wang, Xinmin Fu, Shudong Liu, Shiquan Yang, Shuai Zhang, Zhiming Zhou, Xianjun Huang, Yan Wang, Jun Luo, Yongjie Bai, Min Zhang, Youlin Wu, Guoyong Zeng, Yue Wan, Changming Wen, Hongbin Wen, Wentong Ling, Zhuo Chen, Miao Peng, Zhibing Ai, Fuqiang Guo, Huagang Li, Jing Guo, Haitao Guan, Zhiyi Wang, Yong Liu, Jie Pu, Zhen Wang, Hansheng Liu, Luming Chen, Jiacheng Huang, Guoqiang Yang, Zili Gong, Jie Shuai, Raul G. Nogueira, Qingwu Yang
Summary: This study showed that endovascular treatment alone was noninferior to combined intravenous alteplase and endovascular treatment in achieving functional independence at 90 days among patients with ischemic stroke due to proximal anterior circulation occlusion within 4.5 hours from onset, with no significant differences in safety outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Clinical Neurology
Rongrong Zhang, Hui Wei, Yu Ren, Yanping Wu, Yetao Luo, Lei Zhang, Yingchao Huo, Jinzhou Feng, Philippe P. P. Monnier, Xinyue Qin
Summary: Patients treated with urokinase had similar outcomes but a higher risk of extracranial bleeding compared to patients treated with alteplase. The risk of extracranial bleeding was higher in the patients treated with high-dose urokinase than in the patients treated with low-dose urokinase. Patients who received low-dose urokinase had similar outcomes and complications compared to patients treated with alteplase.
FRONTIERS IN NEUROLOGY
(2021)
Article
Medicine, General & Internal
Kentaro Suzuki, Yuji Matsumaru, Masataka Takeuchi, Masafumi Morimoto, Ryuzaburo Kanazawa, Yohei Takayama, Yuki Kamiya, Keigo Shigeta, Seiji Okubo, Mikito Hayakawa, Norihiro Ishii, Yorio Koguchi, Tomoji Takigawa, Masato Inoue, Hiromichi Naito, Takahiro Ota, Teruyuki Hirano, Noriyuki Kato, Toshihiro Ueda, Yasuyuki Iguchi, Kazunori Akaji, Wataro Tsuruta, Kazunori Miki, Shigeru Fujimoto, Tetsuhiro Higashida, Mitsuhiro Iwasaki, Junya Aoki, Yasuhiro Nishiyama, Toshiaki Otsuka, Kazumi Kimura
Summary: In patients with acute large vessel occlusion stroke, mechanical thrombectomy alone did not show noninferiority compared to combined intravenous thrombolysis plus mechanical thrombectomy in terms of favorable functional outcomes. However, there was also no evidence of inferiority due to wide confidence intervals.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Review
Clinical Neurology
Klearchos Psychogios, Georgios Tsivgoulis
Summary: Despite theoretical concerns about increased bleeding risk, there is no evidence showing higher risk of symptomatic intracerebral hemorrhage (sICH) in patients with stroke mimics who receive intravenous thrombolysis (IVT) using recombinant tissue-plasminogen activator (rt-PA). Recent randomized evidence allows for the expansion of the time window for IVT in acute ischemic stroke (AIS) patients using advanced neuroimaging, including wake-up stroke patients and those presenting within 4.5-9 hours from symptom onset fulfilling certain neuroimaging criteria.
CURRENT OPINION IN NEUROLOGY
(2022)
Review
Clinical Neurology
Pengju Ma, Yi Zhang, Li Chang, Xiangsheng Li, Yuling Diao, Haigang Chang, Lei Hui
Summary: This systematic review and meta-analysis compared the efficacy and safety of tenecteplase with alteplase for the treatment of acute ischemic stroke (AIS) patients. The results showed no significant difference between the two drugs in terms of good outcome and excellent outcome at 90 days. However, patients receiving tenecteplase might have a higher incidence of early neurologic improvement compared to those receiving alteplase.
JOURNAL OF NEUROLOGY
(2022)
Review
Clinical Neurology
Ziyi Shen, Nana Bao, Ming Tang, Yang Yang, Jia Li, Wei Liu, Guohui Jiang
Summary: This meta-analysis found that the clinical application of tenecteplase, one of the drugs for the treatment of acute ischemic stroke (AIS), is still controversial. However, compared to alteplase, tenecteplase is not inferior in terms of safety and efficacy in early thrombolytic therapy for AIS. In fact, tenecteplase showed better results in some efficacy outcomes without significant differences in safety. However, more high-quality prospective clinical studies are still needed to confirm these results.
NEUROLOGY AND THERAPY
(2023)