Transition to newer clot-busting drug improves patient outcomes, lowers cost in treating ischemic stroke (Tenecteplase)

Medical Xpress / University of Texas at Austin / Stroke ^ | Sept. 23, 2022 | Steven Warach, M.D. et al

[ConservativeMind]

A newer-generation clot-busting drug called tenecteplase outperforms the traditional treatment for ischemic strokes in several key areas, including better health outcomes and lower costs, according to a study.

Both tenecteplase and alteplase are federally approved for use in dissolving clots in blocked heart arteries. But the newer drug tenecteplase is also being used by clinicians, off-label, to treat ischemic strokes, because clinical trials in stroke suggest that it may be at least as good as alteplase and it is easier to administer. Tenecteplase is administered by a single five- to 10-second intravenous injection. The researchers compared its performance with the standard drug for stroke, alteplase, which is injected over 60 minutes.

"When it comes to treating patients with a stroke, every second matters," said Warach. "The shorter preparation and injection time with tenecteplase not only eliminates a lot of dosing errors related to alteplase, but it's also more efficient. We were able to deliver the clot-busting medicine more quickly."

For patients who come into the emergency department after a stroke, Warach's study found that the "door-to-needle" time—the time between patients' arrival and the moment they receive treatment—was on average six minutes quicker with tenecteplase. And for patients who also required a thrombectomy, the surgical removal of a blood clot causing the stroke, tenecteplase sped up the process of transferring the patient to a thrombectomy-capable stroke center by 25 minutes.

Researchers also saw improvements in clinical outcomes for patients given tenecteplase, including:

- A 5% increase in patients who were able to walk independently at time of hospital discharge. - A 4% decrease in occurrences of bad events such as brain hemorrhages, discharge to hospice care or death. - The third major improvement: cost. The research team found that tenecteplase treatment cost the hospitals about $2,500 less than alteplase per patient.

[ConservativeMind]

Tenecteplase is an off-label drug for ischemic stroke, so most ER doctors likely won’t know, or feel comfortable, using this.

[ConservativeMind]

The “Take Charge Of Your Health” Ping List
This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20 - 25% fewer pings) or “Everything” list.

[grey_whiskers]

Thanks for posting this.

[deks]

wish they’d had this 35 years ago

[FrogMom]

They gave me TPA (”Tissue plasminogen activator, most commonly known as TPA, is a powerful blood thinner used for emergency stroke treatment.”) after my stroke.