Prospects of Tenecteplase Use for Ischemic Stroke in Evidence-Based Approach
Keywords:stroke, thrombolytic therapy, tenecteplase
Оne of the modern evidence-based methods for treating patients with ischemic stroke is systemic thrombolytic therapy. Only alteplase is allowed for systemic thrombolytic therapy. But this medical drug have restriction to use and a number of serious complications. It causes the need for research other medicines for thrombolysis treating. One of these drugs can be tenecteplase.
The aim of work.To research and generalize evidential data on the use of tenecteplase, as well as to assess its benefits in thrombolytic therapy for ischemic stroke.
Materials and methods. Materials: systematic reviews, results of meta-analyses and clinical trials. Methods: information search, analysis and synthesis, and graphical and mathematical evaluation.
Results. One systematic review, two meta-analyses, and five completed clinical trials were singled out from the Database of Research into Stroke (DORIS) and the Medline database of the National Medical Library of the United States, as well as from clinical trial databases. These findings were utilized to summarize evidential data for tenecteplase use with ischemic stroke. The graphical and mathematical evaluation revealed that according to the following indicators: 24 hour recanalization, functional results after 3 months, benefit/risk ratio, administration method, fibrin-selectivity, half-life and resistance to the inhibitor of the type 1 plasminogen activator, tenecteplase is superior to alteplase, however in terms of the cost the former is inferior to the latter. Competitiveness coefficient of tenecteplase is 4.3 times higher than the one of alteplase.
Conclusions. Based on the chosen comparison criteria, tenecteplase has significant advantages over alteplase and therefore may be used as its likely alternative, given almost similar safety profile and effectiveness, as well as better usability. To confirm or refute this, further large-scale clinical trials are required.
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