Tenecteplase increasingly implemented as standard of care in acute ischemic stroke

Johanna Ospel, PhD, from the University of Basel, Basel, Switzerland, discusses current treatment standards for acute ischemic stroke and how the novel thrombolytic agent tenecteplase has the potential to replace alteplase. The Phase III AcT trial (NCT03889249), conducted in Canada, evaluated tenecteplase, a tissue plasminogen activator similar to alteplase but with higher fibrin specificity. Looking at mRS scores at 90-120 days after treatment, the trial of 1600 patients demonstrated that tenecteplase was non-inferior to alteplase within 4.5 hours of acute ischemic stroke, leading to its adoption as the standard of care in Canada. One advantage of tenecteplase is that it can be administered as a bolus, taking only 10 minutes. In contrast, alteplase requires a 1-hour infusion, resulting in a longer treatment time and complicating patient transfers. The Norwegian government also recognized tenecteplase as the standard of care during the SARS CoV-2 pandemic, acknowledging its benefits in reducing staff exposure time. This interview took place at The BNA 2023 International Festival of Neuroscience in Brighton, UK.

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