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Abstract Number: Esoc2026a1371 Real-World Effectiveness and Safety of Tenecteplase Versus Alteplase in Acute Ischemic Stroke

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Comparative synthesis finds tenecteplase shows comparable outcomes to alteplase in ischemic stroke, suggesting a safe alternative.

This research aims to evaluate the effectiveness and safety of tenecteplase versus alteplase for treating acute ischemic stroke.
Conducted a structured synthesis of real-world studies comparing tenecteplase and alteplase.
Included data from national and multinational stroke registries and propensity score-matched cohorts.
Assessed functional outcomes using the modified Rankin Scale and analyzed rates of symptomatic intracranial hemorrhage and mortality.
Functional outcomes with tenecteplase were comparable to alteplase, with several analyses suggesting improved outcomes in specific groups.
Rates of symptomatic intracranial hemorrhage were similar or lower with tenecteplase, including a significant reduction in one registry.
No increase in mortality was observed with tenecteplase, and some analyses indicated lower mortality rates compared to alteplase.

Martínez et al. (2026) studied this question.

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