Efficacy and safety of tenecteplase in the treatment of acute ischemic stroke：a meta-analysis
- VernacularTitle:替奈普酶治疗急性缺血性脑卒中疗效及安全性的Meta分析
- Author:
Xinyu FENG
1
;
Min WANG
2
;
Wenjun GUO
2
;
Yuntao LI
2
Author Information
1. Dept. of Neurology，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210011，China
2. Dept. of General Practice，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210011，China
- Publication Type:Journal Article
- Keywords:
acute ischemic stroke;
tenecteplase;
alteplase;
efficacy;
safety;
meta-analysis
- From:
China Pharmacy
2023;34(9):1119-1125
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of intravenous bolus of tenecteplase in the treatment of acute ischemic stroke （AIS）， in order to provide evidence-based support for the clinic’s choice of intravenous thrombolytic drugs. METHODS Randomized controlled trials （RCTs） about the efficacy and safety of tenecteplase versus alteplase （control） in the treatment of AIS were collected from PubMed， Embase， the Cochrane Library， Web of Science， Sinomed， CNKI， Wanfang Data， and VIP during the inception to June 2022. Two evaluators independently screened the literature， extracted data from the literature， assessed the bias risk of included study， and then conduct meta-analysis by using Stata 15 software. RESULTS A total of 8 literature were included， involving 2 129 patients. Meta-analysis results showed that the early improvement rate of neurological function [OR（95%CI）＝2.44（1.09，5.46），P＝0.030] and the good rate of neurological function recovery （modified Rankin scale score 0-2 after 90 days of intravenous thrombolysis treatment） [OR（95%CI）＝1.54（1.00，2.36），P＝0.048] were higher in 0.25 mg/kg tenecteplase group （medium dose） than alteplase group. According to meta-analysis of other outcome indicators （including recanalization rate， percentage of reperfusion lesions， excellent rate of neurological function recovery， the incidence rate of bleeding， the incidence rate of symptomatic intraventricular hemorrhage and all-cause mortality rate within 90 d）， the tenecteplase group had no statistically significant difference with alteplase group （P＞0.05）. CONCLUSIONS Compared with alteplase， medium dose of tenecteplase has some advantages in terms of early neurological function improvement and neurological function recovery， and it does not increase the risk of adverse events.
