Muhammad Imtiaz, Muhammad Adnan Zaman, Abeel Naseer, Sidra Kalsoom
{"title":"Role of tenecteplase in ischemic stroke after 4.5 hours: an evaluation of the TRACE-III trial.","authors":"Muhammad Imtiaz, Muhammad Adnan Zaman, Abeel Naseer, Sidra Kalsoom","doi":"10.1080/17512433.2024.2427078","DOIUrl":null,"url":null,"abstract":"<p><p>Tenecteplase (TNK), as a thrombolytic treatment for acute ischemic stroke (AIS), has been found to be effective when used within 4.5 hours of symptom onset. However, the efficacy of TNK after 4.5 hours is not well established, especially in patients with large vessel occlusion and with no access to thrombectomy. In this article, we will discuss the results of the recently published TRACE-III trial. The study involved 516 patients with large vessel occlusion, either proximal middle cerebral artery or internal carotid artery, with salvageable brain tissue and no endovascular thrombectomy access. Key safety outcomes included symptomatic intracranial hemorrhage and death. TNK treatment resulted in a higher percentage of patients with a modified Rankin scale score of 0 or 1 at 90 days than standard medical treatment. Mortality at 90 days was 13.3% with TNK and 13.1% with standard medical treatment. The trial found that TNK treatment for Chinese patients with ischemic stroke resulted in less disability and similar survival compared to standard medical treatment. However, there was a higher incidence of symptomatic intracranial hemorrhage within 36 hours.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"1013-1016"},"PeriodicalIF":3.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Clinical Pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17512433.2024.2427078","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Tenecteplase (TNK), as a thrombolytic treatment for acute ischemic stroke (AIS), has been found to be effective when used within 4.5 hours of symptom onset. However, the efficacy of TNK after 4.5 hours is not well established, especially in patients with large vessel occlusion and with no access to thrombectomy. In this article, we will discuss the results of the recently published TRACE-III trial. The study involved 516 patients with large vessel occlusion, either proximal middle cerebral artery or internal carotid artery, with salvageable brain tissue and no endovascular thrombectomy access. Key safety outcomes included symptomatic intracranial hemorrhage and death. TNK treatment resulted in a higher percentage of patients with a modified Rankin scale score of 0 or 1 at 90 days than standard medical treatment. Mortality at 90 days was 13.3% with TNK and 13.1% with standard medical treatment. The trial found that TNK treatment for Chinese patients with ischemic stroke resulted in less disability and similar survival compared to standard medical treatment. However, there was a higher incidence of symptomatic intracranial hemorrhage within 36 hours.
期刊介绍:
Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery.
Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.