What question did this study set out to answer?

To evaluate the efficacy and safety of tenecteplase for non–large vessel occlusion ischemic stroke administered 4.5 to 24 hours after onset.

February 8, 2026JAMA

Tenecteplase for Acute Non–Large Vessel Occlusion 4.5 to 24 Hours After Ischemic Stroke

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Clinical trial assesses efficacy of tenecteplase for stroke recovery in adults, suggesting improved outcomes but increased risks.

To evaluate the efficacy and safety of tenecteplase for non–large vessel occlusion ischemic stroke administered 4.5 to 24 hours after onset.
Randomized open-label blinded endpoint clinical trial
Conducted across 48 centers in China
Involved 566 patients with non–large vessel occlusion stroke
Participants received either tenecteplase or standard medical treatment
43.6% of patients in the tenecteplase group achieved an excellent functional outcome compared to 34.2% in the control group
Higher incidence of symptomatic intracranial hemorrhage at 2.8% with tenecteplase versus 0% in control
Mortality at 90 days was 5.0% for the tenecteplase group and 3.2% for the control group

Ma et al. (2026) studied this question.

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