Pengju Ma1, Yi Zhang2, Li Chang2, Xiangsheng Li3, Yuling Diao3, Haigang Chang3, Lei Hui4. 1. Department of Neurosurgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China. pengjuma@126.com. 2. Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China. 3. Department of Neurosurgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China. 4. Department of Neurosurgery, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China. 13782586678@163.com.
Abstract
BACKGROUND: At present, studies regarding the efficacy and safety of tenecteplase for the treatment of patients with acute ischemic stroke (AIS) are still limited and inconsistent. The purpose of this systematic review and meta-analysis is to compare the efficacy and safety of tenecteplase with alteplase for the treatment of AIS patients. METHODS: Literature search was conducted in PubMed, Embase, and Cochrane Library up to May 10, 2022. Primary outcomes of this study included 90-day good outcome (defined as an mRS score of 0-2) and 90-day excellent outcome (defined as an mRS score of 0-1). Risk ratios (RRs) with 95% confidence intervals (95% CIs) were calculated using a random-effect model for each outcome. RESULTS: Fourteen studies with a total of 3537 patients were finally included in this meta-analysis. There was no statistical difference between patients receiving tenecteplase and those receiving alteplase in the rates of 90-day good outcome (RR 1.01; 95% CI 0.91-1.13; P = 0.79) and 90-day excellent outcome (RR 1.04; 95% CI 0.92-1.19; P = 0.50). Patients receiving tenecteplase might associated with higher incidence of early neurologic improvement compared with those receiving alteplase (RR 1.29; 95% CI 1.04-1.61; P = 0.02). In addition, no statistical difference was observed between the two groups in other outcomes. CONCLUSION: This meta-analysis indicated that tenecteplase in AIS patients is as safe and effective as alteplase and might provide more benefit than alteplase. However, due to several inherent limitations of this study, more prospective studies should be conducted to confirm the above results.
BACKGROUND: At present, studies regarding the efficacy and safety of tenecteplase for the treatment of patients with acute ischemic stroke (AIS) are still limited and inconsistent. The purpose of this systematic review and meta-analysis is to compare the efficacy and safety of tenecteplase with alteplase for the treatment of AIS patients. METHODS: Literature search was conducted in PubMed, Embase, and Cochrane Library up to May 10, 2022. Primary outcomes of this study included 90-day good outcome (defined as an mRS score of 0-2) and 90-day excellent outcome (defined as an mRS score of 0-1). Risk ratios (RRs) with 95% confidence intervals (95% CIs) were calculated using a random-effect model for each outcome. RESULTS: Fourteen studies with a total of 3537 patients were finally included in this meta-analysis. There was no statistical difference between patients receiving tenecteplase and those receiving alteplase in the rates of 90-day good outcome (RR 1.01; 95% CI 0.91-1.13; P = 0.79) and 90-day excellent outcome (RR 1.04; 95% CI 0.92-1.19; P = 0.50). Patients receiving tenecteplase might associated with higher incidence of early neurologic improvement compared with those receiving alteplase (RR 1.29; 95% CI 1.04-1.61; P = 0.02). In addition, no statistical difference was observed between the two groups in other outcomes. CONCLUSION: This meta-analysis indicated that tenecteplase in AIS patients is as safe and effective as alteplase and might provide more benefit than alteplase. However, due to several inherent limitations of this study, more prospective studies should be conducted to confirm the above results.
Authors: C P Cannon; C M Gibson; C H McCabe; A A Adgey; M J Schweiger; R F Sequeira; G Grollier; R P Giugliano; M Frey; H S Mueller; R M Steingart; W D Weaver; F Van de Werf; E Braunwald Journal: Circulation Date: 1998 Dec 22-29 Impact factor: 29.690
Authors: T Neumann-Haefelin; R du Mesnil de Rochemont; J B Fiebach; A Gass; C Nolte; T Kucinski; J Rother; M Siebler; O C Singer; K Szabo; A Villringer; P D Schellinger Journal: Stroke Date: 2003-12-11 Impact factor: 7.914
Authors: Borja Ibanez; Stefan James; Stefan Agewall; Manuel J Antunes; Chiara Bucciarelli-Ducci; Héctor Bueno; Alida L P Caforio; Filippo Crea; John A Goudevenos; Sigrun Halvorsen; Gerhard Hindricks; Adnan Kastrati; Mattie J Lenzen; Eva Prescott; Marco Roffi; Marco Valgimigli; Christoph Varenhorst; Pascal Vranckx; Petr Widimský Journal: Eur Heart J Date: 2018-01-07 Impact factor: 29.983
Authors: William N Whiteley; Jonathan Emberson; Kennedy R Lees; Lisa Blackwell; Gregory Albers; Erich Bluhmki; Thomas Brott; Geoff Cohen; Stephen Davis; Geoffrey Donnan; James Grotta; George Howard; Markku Kaste; Masatoshi Koga; Rüdiger von Kummer; Maarten G Lansberg; Richard I Lindley; Patrick Lyden; Jean Marc Olivot; Mark Parsons; Danilo Toni; Kazunori Toyoda; Nils Wahlgren; Joanna Wardlaw; Gregory J Del Zoppo; Peter Sandercock; Werner Hacke; Colin Baigent Journal: Lancet Neurol Date: 2016-06-08 Impact factor: 44.182