Tenecteplase is a recombinant tissue plasminogen activator (rt-PA) which has enhanced fibrin specificity, relatively long half-life, and allows single-bolus intravenous administration. Studies have shown that Tenecteplase has similar safety profile and non-inferior compared to Alteplase in acute ischaemic stroke. Recent data suggest that Tenecteplase may produce higher recanalisation rate, and improve clinical outcome compared to Alteplase in patients with acute ischaemic stroke.
To our knowledge, Tenecteplase is not approved by regulatory authorities for the treatment of acute ischemic stroke – further trials are ongoing. We are aware of that a number of centres already are using off label Tenecteplase in acute ischemic stroke, since the drug is available on the market for the treatment of myocardial infarction.
We have now added the option to record Tenecteplase in the SITS i.v thrombolysis data entry forms for centres using the drug. This does not mean that we recommend use of Tenecteplase instead of Alteplase in acute ischemic stroke, but if centres are already using Tenecteplase off label, we believe monitoring of this treatment is even more important. Collection of sufficient amount of data will enable comparison of Tenecteplase with Alteplase in a retrospective study.