The bolus thrombolytic, tenecteplase, was non-inferior to alteplase, which is given by a bolus followed by an infusion, for functional outcomes in acute ischemic stroke patients treated within 4½ hours of symptom onset in the ATTEST-2 randomized clinical trial.
The results were presented by Keith Muir, MBChB, consultant neurologist, University of Glasgow, UK, at the World Stroke Conference 2023, held last week in Toronto — and they were greeted by applause from the audience.
"This result adds to the growing evidence that tenecteplase should be a first-line thrombolytic agent for the treatment of suitable acute ischemic stroke patients and has significant advantages over current treatment in its ease of use," Muir concluded.
Commenting on the study for theheart.org | Medscape Cardiology, Raul Nogueira, MD, professor of neurology & neurosurgery at the University of Pittsburgh School of Medicine, said: "ATTEST-2 adds to the body of evidence that confirms that tenecteplase is non-inferior and may be superior to alteplase. Even if superiority cannot be fully confirmed, the easy logistics and better cost profile of tenecteplase support its use."
Nogueira added that the University of Pittsburgh health system "completely switched to tenecteplase over 2 years ago and we have seen improvements in time metrics, a better safety profile, and significant cost savings."
