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Frontiers in neurology · 2026

Tenecteplase in acute ischemic stroke: an updated meta-analysis.

СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Almohammed Hussain, Morad Ahmed Salah, Bin Saddiq Bushra Wadi, Almuhaysin Fatimah Ibrahim, Al Zoabi Bayan Mohammed Khair, Aldawsari Wejdan Ahmed, Khan Tanveer Nidal, Thalib Husna Irfan, Alabdi Zainab

Аннотация

INTRODUCTION: Tenecteplase (TNK) has emerged as a promising alternative to alteplase (tPA) for intravenous thrombolysis in acute ischemic stroke (AIS). This study aimed to evaluate the efficacy and safety of TNK compared with tPA.

METHODS: Following the PRISMA 2020 guidelines, PubMed, Web of Science, Cochrane Central, EBSCO, and Scopus were systematically searched from inception through January 2026 to identify randomized controlled trials (RCTs) and observational studies comparing TNK with tPA in adults with AIS. Effect estimates were pooled using fixed- or random-effects models according to the degree of heterogeneity and were reported as risk ratios (RRs), odds ratios (ORs), or mean differences (MDs) with 95% confidence intervals (CIs).

RESULTS: Twenty-four studies (6 RCTs and 18 observational studies; total n = 20,592) involving patients with AIS were included. Compared with tPA, TNK was associated with a greater likelihood of excellent functional recovery (mRS 0-1) at 90 days (RR = 1.08; 95% CI: 1.01-1.15; p = 0.02) and a shorter door-to-needle time by an average of 4 min (MD = -4.20; 95% CI: -7.77 to -0.64; p = 0.02). Mortality was lower among patients treated with TNK (OR = 0.83; 95% CI: 0.73-0.94; p = 0.004). However, subgroup analyses restricted to RCTs showed no significant difference in mortality between the TNK and tPA groups (OR = 0.99; 95% CI: 0.82-1.21; p = 0.95).

CONCLUSION: TNK provides efficacy and safety profiles comparable to those of tPA while offering a greater likelihood of excellent functional recovery, faster treatment initiation, and lower mortality in observational studies. Further high-quality RCTs are warranted to confirm these findings.

SYSTEMATIC REVIEW REGISTRATION: CRD420251030320.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты