For sufferers with acute ischemic stroke because of large-vessel occlusion who current inside 4.5 hours, intravenous tenecteplase earlier than endovascular thrombectomy is related to greater purposeful independence at 90 days, in accordance with a research revealed on-line Might 21 within the New England Journal of Drugs to coincide with the annual European Stroke Organisation Convention, held from Might 21 to 23 in Helsinki.
Zhongming Qiu, M.D., from the Second Affiliated Hospital of Military Medical College in Chongqing, China, and colleagues performed an open-label trial in China involving sufferers with acute ischemic stroke because of large-vessel occlusion who introduced inside 4.5 hours after onset and have been eligible for thrombolysis.
Individuals have been randomly assigned to obtain both intravenous tenecteplase adopted by endovascular thrombectomy or endovascular thrombectomy alone (278 and 272 sufferers, respectively). The first consequence was purposeful independence (a rating of 0 to 2 on the modified Rankin scale, with greater scores indicating extra extreme incapacity) at 90 days.
The researchers discovered that 52.9% and 44.1% of sufferers within the tenecteplase-thrombectomy group and the thrombectomy-alone group, respectively, had purposeful independence at 90 days (unadjusted threat ratio, 1.20).
Total, 6.1% and 1.1% of sufferers, respectively, within the tenecteplase-thrombectomy group and the thrombectomy-alone group had profitable reperfusion earlier than thrombectomy, whereas 91.4% and 94.1%, respectively, had profitable reperfusion after thrombectomy.
Symptomatic intracranial hemorrhage inside 48 hours occurred in 8.5% and 6.7% of sufferers, respectively, within the tenecteplase-thrombectomy group and the thrombectomy-alone group; mortality at 90 days was 22.3% and 19.9%, respectively.
“The lack of a consistent significant benefit across secondary outcomes makes this finding tenuous,” the authors write.
The research was funded partially by China Shijiazhuang Pharmaceutical Firm Recomgen Pharmaceutical.
Extra info:
Zhongming Qiu et al, Intravenous Tenecteplase earlier than Thrombectomy in Stroke, New England Journal of Drugs (2025). DOI: 10.1056/NEJMoa2503867
European Stroke Organisation Convention, eso-stroke.org/esoc2025/
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Intravenous tenecteplase useful earlier than endovascular thrombectomy (2025, Might 25)
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