AI Summary
This article discusses the use of tenecteplase as a thrombolytic agent for acute ischaemic stroke, comparing it to alteplase. Tenecteplase has been shown to be non-inferior to alteplase in recent trials, with practical advantages such as a longer plasma half-life and the ability to be delivered as a bolus injection. Additionally, tenecteplase is more fibrin-selective than alteplase, making it more effective in binding to fibrin. This suggests that tenecteplase may offer improved efficiency in thrombolysis for acute ischaemic stroke compared to alteplase.
Alteplase, a recombinant form of tissue plasminogen activator, has been the sole thrombolytic treatment available since the 1990s. However, in the past few years, several randomised trials have shown non-inferiority of tenecteplase to alteplase.1–4 This new thrombolytic agent is a modified but closely related variant of alteplase that has a longer plasma half-life and can be delivered as a bolus injection, providing a practical advantage over alteplase. Tenecteplase is also more fibrin-selective than alteplase, meaning that it binds more effectively to fibrin than fibrinogen.