Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe 
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  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Thrombolytic Therapy for Non-arteritic Central Retinal Artery Occlusion in an Academic Multi-site Stroke Center (Both in-person and online) -  Mar 12, 2023 - Abstract #AAN2023AAN_4359;    
    11/20 (55%) received additional therapies (ocular massage, intraocular pressure lowering drops, diuretics, intra-arterial verapamil)...Most received a combination of thrombolytic and other conventional therapies, hence thrombolysis-specific outcomes could not be described. Prospective studies comparing thrombolysis and placebo are warranted to guide hyperacute CRAO practice.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Alteplase-induced facial orolingual angioedema (Both in-person and online) -  Mar 12, 2023 - Abstract #AAN2023AAN_3888;    
    Newer analyses need to focus on direct comparison of tenecteplase doses and whether tenecteplase is efficacious at longer needle times. Background r-TPA induced angioedema is a common clinical finding after medication infusion for acute stroke.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Tenecteplase Versus Alteplase for Acute Ischemic Stroke in a Community Hospital Setting (Both in-person and online) -  Mar 12, 2023 - Abstract #AAN2023AAN_2850;    
    Design/Methods We conducted a multicenter, simulation-based study of neurology residents Mortality in the tenecteplase group and no thrombolytic groups was 2%, compared to 3% in the alteplase group.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Infarct Topography and Reperfusion Injury After Endovascular Thrombectomy for Large Vessel Occlusion Stroke (Both in-person and online) -  Mar 12, 2023 - Abstract #AAN2023AAN_2402;    
    Intravenous alteplase was administered to 52%; 70% achieved TICI 2b-3 reperfusion...Conclusions Greater basal ganglia infarct volume was associated with a higher risk of HT when accounting for infarct volumes in other regions. Susceptibility vessel sign was associated with basal ganglia infarct volume, which may be related to acute middle cerebral artery perforator occlusion.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    CT Perfusion Imaging Guides Clinical Decision Making in a Case of Thalamic Stroke (Both in-person and online) -  Mar 12, 2023 - Abstract #AAN2023AAN_1766;    
    She was administered intravenous alteplase and admitted...Conclusions The clinical utility of perfusion neuroimaging extends beyond current clinical guidelines. Proficiency in study interpretation and correlation between patient presentation and neuroanatomical structures affected by perfusion deficits may allow additional stroke patients to receive treatment, particularly in atypical presentations of stroke such as altered mental status.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Trial completion date, Trial primary completion date:  ORIGINAL: A Study in Chinese Patients to Compare How Tenecteplase and Alteplase Given After a Stroke Improve Recovering of Physical Activity (clinicaltrials.gov) -  Mar 8, 2023   
    P3,  N=1490, Recruiting, 
    Further studies are needed to confirm these results in patients with larger core volumes and more unfavorable baseline perfusion profiles on CTP imaging. Trial completion date: Jul 2023 --> Oct 2023 | Trial primary completion date: Jul 2023 --> Oct 2023
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Clinical, Retrospective data:  Comparative Efficacy and Safety of Thrombolytic Agents for Pulmonary Embolism: A Bayesian Network Meta-Analysis. (Pubmed Central) -  Mar 7, 2023   
    Tenecteplase did not reduce mortality compared with anticoagulants alone and may not be a good choice of thrombolytic agent due to an increase in minor bleeding compared with streptokinase and anticoagulants alone. Thrombolytic drugs should be rationally selected to optimize the thrombolytic regimen and achieve as good a balance as possible between thrombolysis and bleeding.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Advances in the management of acute ischemic stroke. (Pubmed Central) -  Mar 6, 2023   
    These data along with the practical advantages of TNK have resulted in a shift to replace intravenous TNK as the standard for thrombolysis. Ongoing studies of IVT with TNK are focussed on defining the optimal dose, expanding the time window with multimodal imaging and defining the role of thrombolysis for bridging patients with stroke due to large vessel occlusion.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Tenecteplase Improves Reperfusion Across Time in Large Vessel Stroke. (Pubmed Central) -  Mar 2, 2023   
    Prethrombectomy reperfusion is associated with better clinical outcomes. ANN NEUROL 2023;93:489-499.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Journal:  Efficacy and safety of alteplase on treatment of acute single small subcortical infarction. (Pubmed Central) -  Mar 2, 2023   
    ANN NEUROL 2023;93:489-499. Patients with SSSI in the anterior circulation are more likely to achieve 3 months favorable outcomes than those who were treated with standard medical care; however, treatment with alteplase may not prevent the occurrence of END.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Review, Journal:  Eriodictyol: a review of its pharmacological activities and molecular mechanisms related to ischemic stroke. (Pubmed Central) -  Feb 27, 2023   
    Meanwhile, patients benefit little from the limited clinical strategies of intravenous alteplase and thrombectomy due to the limited therapeutic window...Nevertheless, the mechanism of ERD against IS is flawed and needs more exploration by the research community. Moreover, well-designed clinical trials are needed to increase the scientific validity of the beneficial effects of ERD against IS.
  • ||||||||||  Aggrastat (tirofiban) / Correvio, Medicure, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Enrollment closed, Combination therapy:  RESET: A Study Evaluating the Safety and Efficacy of Tirofiban in Combination With Alteplase in Acute Ischemic Stroke (clinicaltrials.gov) -  Feb 23, 2023   
    P2,  N=266, Active, not recruiting, 
    Moreover, well-designed clinical trials are needed to increase the scientific validity of the beneficial effects of ERD against IS. Recruiting --> Active, not recruiting
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Observational data, Retrospective data, Journal:  Systemic thrombolytics as rescue therapy for COVID-19 patients with acute respiratory distress syndrome: A retrospective observational study. (Pubmed Central) -  Feb 13, 2023   
    Patients with severe ARDS and d-dimer levels of 5 ?g/ml or above were initiated on alteplase, as a 25 mg bolus followed by a 25 mg infusion over 22 h. Primary outcome was intensive care unit (ICU) mortality and secondary outcomes were change in PaO2/FiO2 24 h after thrombolysis, avoidance of intubation, ventilator free days (VFD), and ICU and hospital length-of-stay (LOS)...Thrombolysis can be considered as a rescue therapy for nonintubated COVID-19 ARDS patients with severe hypoxemic respiratory failure, who show evidence of a procoagulant state. Larger studies are needed before inclusion into the regular treatment protocol for COVID-19 patients.
  • ||||||||||  TNKASE (tenecteplase) / Roche, Boehringer Ingelheim, Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    Retrospective data, Review, Journal:  Tenecteplase vs. alteplase for treatment of acute ischemic stroke: A systematic review and meta-analysis of randomized trials. (Pubmed Central) -  Feb 10, 2023   
    Further analysis comparing dosing of tenecteplase (0.1, 0.25, 0.32, and 0.4 mg/kg) yielded no significant differences for any of the endpoints (mRS 0-1, mRS 0-2, sICH, and mortality) compared to alteplase. Based on available evidence from completed RCTs, tenecteplase has proven similar safety and efficacy to alteplase for treatment of AIS.