Tenecteplase
Tenecteplase in Minor Stroke: Does Vessel Occlusion Change the Answer? — TEMPO-2 Secondary Analysis
Baseline occlusion status did not identify a minor-stroke subgroup with improved 90-day recovery after tenecteplase versus non-thrombolytic care in TEMPO-2.
Tenecteplase in Large-Vessel Occlusion — Bridging, Extended-Window, and the 4.5-Hour Wall
Meta-analysis of five RCTs (n=2,054) finds IV tenecteplase improves mRS outcomes in LVO versus no thrombolysis; bridging within 4.5 h before EVT and extended-window use without EVT show benefit, but bridging 4.5–24 h does not.
Intra-Arterial Tenecteplase After Successful Reperfusion in Large Vessel Occlusion Stroke
DATE: adjunctive intra-arterial tenecteplase at 0.0313 or 0.0625 mg/kg after successful reperfusion is safe to advance to a phase 3 trial, with a numerically higher but non-significant 90-day no-disability rate (43.5% vs 33.8% control).
Thrombus Migration After Tenecteplase Versus Alteplase in Acute Large Vessel Occlusion
In a matched multicenter cohort of 746 large-vessel-occlusion patients undergoing bridging therapy, tenecteplase produced nearly twice the thrombus migration of alteplase (19.3% vs 11.3%), concentrated in the first 60 minutes after IVT, and migration independently predicted functional independence.
Deep-Dive: T-FLAVOR — Tenecteplase 0.25 mg/kg vs Low-Dose Alteplase in LVO Stroke
T-FLAVOR Japanese phase 2 (n=218): tenecteplase vs low-dose alteplase for LVO bridging — substantial reperfusion 10.3% vs 3.6% (90% CI 0.89–12.1; 95% CI −0.19% to 13.2%; mRS shift favors TNK numerically).