Administration of IV tenecteplase promising to treat ischemic stroke within mobile unit

Key takeaways:

• The study included 72 individuals with ischemic stroke given alteplase and tenecteplase.
• No significant time difference was observed for both therapies from mobile stroke unit door to administration.

For individuals who suffer an ischemic stroke, IV administration of tenecteplase within a mobile stroke unit favorably compared with alteplase perfusion, according to preliminary data presented at the International Stroke Conference.

“Tenecteplase administered on a mobile stroke unit has demonstrated superior rates of early reperfusion compared to alteplase,” J. Tyler Haller, PharmD, lead study author and clinical pharmacy specialist in neurocritical care at St. Joseph’s Hospital and Medical Center in Phoenix, said in his presentation. “Current guidelines include tenecteplase as a second-tier option for large vessel occlusions as it has many benefits, including rapid IV administration and ease of dosing.”

Haller and colleagues sought to provide context for the utilization and efficacy of IV-administered tenecteplase compared with alteplase perfusion within a specialized mobile stroke unit (MSU) ambulance.

Their retrospective observational study was conducted between February 2021 and April 2023 at a large academic comprehensive stroke center. The study included 72 individuals (median age 65.7 years; median NIH Stroke Scale score = 9); 40 received alteplase and 32 received tenecteplase. Data such as baseline demographics, Glasgow Coma Scale score, NIHSS, and time of imaging were collected when initial imaging was undertaken for the study population.

The primary endpoint for the study was time from initial interaction with the mobile stroke unit to thrombolytic administration, with secondary endpoints including MSU door to imaging interpretation, dispatch to thrombolytic administration and provider decision time to thrombolytic administration. Safety endpoints included symptomatic intracerebral hemorrhage within 24 hours.

No significant difference was found in time elapsed from MSU door to thrombolytic administration (15 minutes vs. 17.5 minutes), according to results.

Haller and colleagues also found no difference in time from MSU door to imaging interpretation, dispatch to thrombolytic administration or provider decision time to thrombolytic administration. Additionally, no hemorrhagic conversion occurred among the study population.

“Apart from being less expensive, our results confirm tenecteplase is safe and as effective as alteplase,” Haller said in a related release. “We anticipate that other mobile stroke units across the country will begin to utilize tenecteplase if they are not already.”

Reference:

• New clot-busting medication simplified stroke treatment in specialized ambulance. https://newsroom.heart.org/news/new-clot-busting-medication-simplified-stroke-treatment-in-specialized-ambulance?preview=eff9&preview_mode=True. Published Feb. 1, 2024. Accessed Feb. 6, 2024.