Stroke drug comparison favors tenecteplase on a specific recovery measure
Pooled trial results favored tenecteplase for excellent functional recovery. Other findings depended on the outcome and whether doses were analyzed together or separately.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
The pooled pairwise comparison favored tenecteplase for excellent functional outcomes. It detected no significant differences in good or poor functional outcomes, major neurological improvement within 72 hours, symptomatic bleeding inside the skull, or mortality at 90 days. Separate network comparisons found advantages for particular doses on specific functional outcomes.
The abstract omits functional-outcome assessment timing and absolute outcome rates. Nonsignificant safety findings do not establish equivalence, and treatment rankings alone cannot establish a safety advantage.
What researchers found
Excellent functional outcome: mRS 0–1
Pooled tenecteplase versus alteplase; assessment timing not reported in the abstract.
Reading the relative result
The risk ratio describes the specified outcome as 1.04 times as likely with tenecteplase as with alteplase. It compares relative likelihoods; it does not state how many additional patients achieved that outcome.
Dose comparisons and rankings differ
Specific doses favored tenecteplase for excellent and good functional outcomes in the network analysis. This differs from pooling doses together. The analysis also ranked treatments for bleeding, but a ranking alone does not demonstrate a safety difference.
The original publication
Comparative Efficacy and Safety of Different Tenecteplase Doses With Alteplase in Acute Ischemic Stroke: A Systematic Review With Pairwise and Network Meta-Analysis to Determine the Optimal Dose.
Waseem MH, Abideen ZU, Khan MH et al.
Brain Behav · 2025
- PubMed ID
- 40827614
- Record checked
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