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Tenecteplase versus alteplase for acute ischaemic stroke: a meta-analysis of phase III randomised trials

Yunyun Xiong, Liyuan Wang, Guangshuo Li, Kai-Xuan Yang, Manjun Hao, Shuya Li, Yuesong Pan, Yongjun Wang
DOI: 10.1136/svn-2023-002396 Published 27 August 2024
Yunyun Xiong
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
3 Chinese Institute for Brain Research, Beijing, China
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Liyuan Wang
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Guangshuo Li
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Kai-Xuan Yang
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Manjun Hao
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Shuya Li
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yuesong Pan
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yongjun Wang
1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
4 Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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    Figure 1

    Study flow chart.

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    Figure 2

    Comparisons of three included clinical trials. AcT, Tenecteplase in Patients With Acute Ischaemic Stroke; DWI, diffusion-weighted imaging; EVT, endovascular treatment; FLAIR, fluid-attenuated inversion recovery; NIHSS, National Institutes of Health Stroke Scale; NOR-TEST, Norwegian Tenecteplase Stroke; rhTNK-tPA, recombinant human tissue-type plasminogen activator; TRACE-2, Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Ebemts-2.

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    Figure 3

    Risk of bias assessment for efficacy and safety outcomes. Risk of bias legend. AcT, Tenecteplase in Patients With Acute Ischaemic Stroke; D, Bias due to deviations from intended interventions; Me, Bias in measurement of the outcome; Mi, Bias due to missing outcome data; NOR-TEST, Norwegian Tenecteplase Stroke; O, overall risk of bias; R, bias arising from the randomisation process; S, bias in selection of the reported result; TRACE-2, Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-2.

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    Figure 4

    Forest plot for efficacy outcomes. (A) mRS 0–1, (B) mRS 0–2, (C) mRS 5–6, (D) major neurological improvement. AcT, Tenecteplase in Patients With Acute Ischaemic Stroke; mRS, modified Rankin Scale; NOR-TEST, Norwegian Tenecteplase Stroke; RD, risk difference; TRACE-2, Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-2.

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    Figure 5

    Forest plot for safety outcomes. (A) Symptomatic intracerebral haemorrhage, (B) Parenchymal haematoma type 2, (C) any intracerebral haemorrhage, (D) 90-day death. AcT, Tenecteplase in Patients With Acute Ischaemic Stroke; NOR-TEST indicates Norwegian Tenecteplase Stroke; TRACE-2, Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-2.

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    [svn-2023-002396supp001.pdf]

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Tenecteplase versus alteplase for acute ischaemic stroke: a meta-analysis of phase III randomised trials
Yunyun Xiong, Liyuan Wang, Guangshuo Li, Kai-Xuan Yang, Manjun Hao, Shuya Li, Yuesong Pan, Yongjun Wang
Stroke and Vascular Neurology Aug 2024, 9 (4) 360-366; DOI: 10.1136/svn-2023-002396

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Tenecteplase versus alteplase for acute ischaemic stroke: a meta-analysis of phase III randomised trials
Yunyun Xiong, Liyuan Wang, Guangshuo Li, Kai-Xuan Yang, Manjun Hao, Shuya Li, Yuesong Pan, Yongjun Wang
Stroke and Vascular Neurology Aug 2024, 9 (4) 360-366; DOI: 10.1136/svn-2023-002396
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Tenecteplase versus alteplase for acute ischaemic stroke: a meta-analysis of phase III randomised trials
Yunyun Xiong, Liyuan Wang, Guangshuo Li, Kai-Xuan Yang, Manjun Hao, Shuya Li, Yuesong Pan, Yongjun Wang
Stroke and Vascular Neurology Aug 2024, 9 (4) 360-366; DOI: 10.1136/svn-2023-002396
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