Tenecteplase vs. alteplase for the treatment of patients with acute ischemic stroke: a systematic review and meta-analysis

被引：30

作者：

Ma, Pengju ^{[1
]}

Zhang, Yi ^{[2
]}

Chang, Li ^{[2
]}

Li, Xiangsheng ^{[1
]}

Diao, Yuling ^{[1
]}

Chang, Haigang ^{[1
]}

Hui, Lei ^{[1
]}

机构：

[1] Xinxiang Med Univ, Dept Neurosurg, Affiliated Hosp 1, Weihui 453100, Henan, Peoples R China

[2] Xinxiang Med Univ, Dept Neurol, Affiliated Hosp 1, Weihui 453100, Henan, Peoples R China

来源：

JOURNAL OF NEUROLOGY | 2022年 / 269卷 / 10期

关键词：

Tenecteplase; Alteplase; Ischemic stroke; Thrombolysis; Meta-analysis; ACUTE MYOCARDIAL-INFARCTION; TISSUE-PLASMINOGEN ACTIVATOR; FRONT-LOADED ALTEPLASE; REAL-WORLD EXPERIENCE; BLINDED END-POINT; OPEN-LABEL; FIBRINOLYTIC THERAPY; ARTERY-OCCLUSION; RANDOMIZED-TRIAL; NOR-TEST;

D O I：

10.1007/s00415-022-11242-4

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background At present, studies regarding the efficacy and safety of tenecteplase for the treatment of patients with acute ischemic stroke (AIS) are still limited and inconsistent. The purpose of this systematic review and meta-analysis is to compare the efficacy and safety of tenecteplase with alteplase for the treatment of AIS patients. Methods Literature search was conducted in PubMed, Embase, and Cochrane Library up to May 10, 2022. Primary outcomes of this study included 90-day good outcome (defined as an mRS score of 0-2) and 90-day excellent outcome (defined as an mRS score of 0-1). Risk ratios (RRs) with 95% confidence intervals (95% CIs) were calculated using a random-effect model for each outcome. Results Fourteen studies with a total of 3537 patients were finally included in this meta-analysis. There was no statistical difference between patients receiving tenecteplase and those receiving alteplase in the rates of 90-day good outcome (RR 1.01; 95% CI 0.91-1.13; P = 0.79) and 90-day excellent outcome (RR 1.04; 95% CI 0.92-1.19; P = 0.50). Patients receiving tenecteplase might associated with higher incidence of early neurologic improvement compared with those receiving alteplase (RR 1.29; 95% CI 1.04-1.61; P = 0.02). In addition, no statistical difference was observed between the two groups in other outcomes. Conclusion This meta-analysis indicated that tenecteplase in AIS patients is as safe and effective as alteplase and might provide more benefit than alteplase. However, due to several inherent limitations of this study, more prospective studies should be conducted to confirm the above results.

引用

页码：5262 / 5271

页数：10

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