TNKASE (tenecteplase) / Roche, Boehringer Ingelheim - LARVOL DELTA

Adjunctive Thrombolytics After Successful Endovascular Reperfusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Ann Neurol) - "IAT following successful EVT significantly enhances the likelihood of achieving an excellent functional outcome, particularly in anterior circulation strokes. Although the benefit in posterior circulation strokes remains uncertain, the lack of significant differences in sICH risk and mortality across thrombolytic drugs and stroke locations support the safety of IAT. ANN NEUROL 2025."

Journal • Retrospective data • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders

Group 5: beyond the norm: exploring unique profiles of high-risk PE, including the role of the mechanical circulatory system (ERS 2025) - "Learning objectives: a. Absolute and relative CI of tPA: pros and cons of tPA, including Alteplase vs Tenecteplase. c. Role of ECMO as a bridge to Sx or Percutaneous embolectomy."

Cardiovascular • Pulmonary Embolism • Respiratory Diseases

N-acetylcysteine (NAC) as an adjunct to intravenous fibrinolysis in patients with acute ischemic stroke: a single group study (NAC-Safety). (PubMed, Neuroscience) - "Recombinant tissue plasminogen activator (alteplase) and its derivative tenecteplase are approved for acute ischemic stroke (AIS), but their low recanalization rates remain a limitation. NAC administration resulted in a significant reduction in circulating large VWF multimers within hours of administration (-82 % for ULMWM-VWF, p < 0.001), aligning with preclinical findings. While NAC effectively cleaved circulating large VWF multimers in AIS patients, its combination with alteplase raises safety concerns, particularly in patients with a history of antiplatelet therapy."

Journal • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Ischemic stroke • Thrombosis

Safety of thrombolysis in acute ischemic stroke patients with previous aortic abdominal aneurysm repair. (PubMed, J Stroke Cerebrovasc Dis) - "The incidence of AAA rupture after thrombolytic therapy in patients with prior repair was low. Larger studies are needed to determine whether rapid abdominal CTA could identify high-risk features and prevent life-threatening complications."

Journal • Cardiovascular • Ischemic stroke

Faster Thrombolysis Is Associated With Improved Cognitive Outcomes in Patients With Acute Ischemic Stroke Treated With Alteplase and Tenecteplase: A Substudy of the AcT Trial. (PubMed, Stroke) - P3 | "Faster OTN time, with either alteplase or tenecteplase, was associated with higher T-MoCA scores and reduced the likelihood of impairment at 90 days. Faster thrombolytic treatment may reduce cognitive burden after stroke."

Clinical • Journal • Alzheimer's Disease • Cardiovascular • Cognitive Disorders • Ischemic stroke

Neuronavigation-assisted stereotactic minimally invasive puncture with tenecteplase for the treatment of acute spontaneous deep intracerebral haemorrhage (NAS-TNK): rationale and design of a multicentre randomised trial. (PubMed, Stroke Vasc Neurol) - "The NAS-TNK study will help improve our understanding of the benefits of NAS-TNK in patients with acute spontaneous deep ICH."

Journal • Cerebral Hemorrhage • Hematological Disorders

Intravenous tenecteplase is associated with a higher incidence of thrombus movement before endovascular treatment for acute ischemic stroke: a secondary analysis of the AcT randomized controlled trial. (PubMed, J Neurointerv Surg) - "IV tenecteplase is associated with higher thrombus migration rates before EVT compared with alteplase, which is linked to better functional outcomes. However, the type of thrombolytic agent did not affect final reperfusion and functional outcomes."

Journal • Cardiovascular • CNS Disorders • Ischemic stroke • Thrombosis

Tenecteplase in ReperfUsion Therapy for Posterior Circulation Stroke With Extended Time Window: the TRUST Trial (clinicaltrials.gov) - P3 | N=330 | Not yet recruiting | Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University

New P3 trial • Cardiovascular • Ischemic stroke

Mechanical Thrombectomy for TRACE-III-Eligible Patients With Ischemic Stroke: A Multicenter Retrospective Study Compared to TRACE-III and TIMELESS Trials. (PubMed, Ann Clin Transl Neurol) - "In clinical practice, MT can achieve higher rate of early-stage reperfusion and tended to yield better functional outcomes than intravenous TNK, with similar safety, in TRACE-III-eligible patients."

Journal • Retrospective data • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Ischemic stroke

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. (PubMed, Brain Behav) - "TNK (0.25-0.32 mg/kg) demonstrates superior efficacy compared to alteplase in achieving functional outcomes for AIS, while alteplase remains safer regarding sICH. Optimal dosing favors TNK 0.25 mg/kg for efficacy, but safety considerations highlight the need for individualized thrombolytic selection."

Journal • Retrospective data • Review • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Ischemic stroke

Novel thrombolytic agents for acute ischemic stroke: A comprehensive review of current evidence. (PubMed, J Neurol Sci) - "Over the last decades, alteplase (recombinant tissue type plasminogen activator, rt-PA) has been established as the main thrombolytic agent worldwide...This review summarizes current clinical evidence and emerging research on novel thrombolytic agents in acute ischemic stroke, including tenecteplase, reteplase, desmoteplase, urokinase, staphylokinase, JX10, LT3100, Ancrod, and TS23. Among these agents, tenecteplase has been most extensively studied and is already recommended for selected indications by the European Stroke Organization (ESO) and the American Heart Association and American Stroke Association (AHA/ASA). Other agents are still undergoing early clinical investigation and show different levels of potential in terms of effectiveness, safety, and ease of administration."

Journal • Cardiovascular • Ischemic stroke

PEARL-DOAC: Tenecteplase for Intravenous Stroke Thrombolysis in Recent DOAC Users (clinicaltrials.gov) - P3 | N=912 | Not yet recruiting | Sponsor: Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

New P3 trial • Cardiovascular • Ischemic stroke

Administration of Tenecteplase Prior to Complex Open Heart Surgery (ASA 2025) - "He received 3 units pRBCs, 1275 ml of cell saver, 4 units of platelets, 7 units of FFP, 6 units of cryoprecipitate, 1,000 units of PCC, and 3,450 units of fibrinogen concentrate. The patient's neurologic function returned to baseline post-operatively."

Surgery • Cardiovascular • Hypertension • Ischemic stroke

CHABLIS-NEXT: CHinese ischEmic Stroke Beyond 4.5 Hours With TeNecteplase Under Optimized Non-Contrast CT Selection (clinicaltrials.gov) - P3 | N=890 | Not yet recruiting | Sponsor: Huashan Hospital | Trial completion date: Nov 2027 ➔ Jun 2028 | Initiation date: Jun 2025 ➔ Nov 2025 | Trial primary completion date: Nov 2027 ➔ Mar 2028

Trial completion date • Trial initiation date • Trial primary completion date • Cardiovascular • Ischemic stroke

When Seconds Count: Acute Pulmonary Embolism and Critical Care Crisis Management (ASA 2025) - "Tenecteplase was given peri-code with intermittent return of spontaneous circulation. Early recognition and treatment of PE is crucial for more favorable patient outcomes postoperatively.5"

Cardiovascular • Critical care • Pulmonary Embolism • Respiratory Diseases

Efficacy and Safety of Tenecteplase Intravenous Thrombolysis in Acute Posterior Circulation Ischemic Stroke Within 4.5-24 Hours After Onset (clinicaltrials.gov) - P=N/A | N=406 | Not yet recruiting | Sponsor: The First Affiliated Hospital of University of Science and Technology of China

New trial • Cardiovascular • Ischemic stroke

Post-thrombectomy Intra-arterial Tenecteplase for Acute manaGement of Non-retrievable Thrombus and No-reflow in Emergent Stroke (clinicaltrials.gov) - P2/3 | N=462 | Recruiting | Sponsor: University of Melbourne | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • CNS Disorders • Ischemic stroke • Thrombosis • Vascular Neurology

ARTS-MeVO: Advancing Reperfusion Therapy for Ischemic Stroke (ARTS): Tenecteplase in Medium Vessel Occlusion (MeVO) for Acute Ischemic Stroke (clinicaltrials.gov) - P3 | N=596 | Recruiting | Sponsor: Beijing Tiantan Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Ischemic stroke

Tenecteplase in Practice: A Rural Tele-Stroke Network's Experience. (PubMed, J Stroke Cerebrovasc Dis) - "The system-wide transition to TNK resulted in similar safety profiles and treatment times, with notable improvements in procedural efficiency and functional outcomes for patients with LVO. These findings support the broader adoption of TNK as a viable alternative to tPA in acute ischemic stroke management, particularly in telestroke networks and rural communities where staffing and infrastructure may be constrained."

Clinical • Journal • Cardiovascular • Hematological Disorders • Ischemic stroke

Stereotactic thrombolysis with Tenecteplase for Supratentorial Intracerebral Hemorrhage (STEPS) (ChiCTR) - P2/3 | N=844 | Not yet recruiting | Sponsor: Tongji Hospital, Tongji Medical College ,Huazhong University of Science and Technology; Tongji Hospital, Tongji Medical College ,Huazhong University o

New P2/3 trial • Cerebral Hemorrhage • Hematological Disorders

A Life-Threatening Finding From Hypercoagulable States in DKA With Controversial Treatment. (PubMed, Adv Emerg Nurs J) - "Hyperglycemia and insulin resistance contribute to increased platelet sensitivity, coagulation factor abnormalities, and impaired fibrinolysis (Li et al., 2021). This article delves into the identification and treatment of DKA complicated by the pro-thrombotic state, presenting a contentious treatment approach."

Journal • Cardiovascular • Diabetes • Hematological Disorders • Metabolic Disorders • Respiratory Diseases • Thrombosis • Type 1 Diabetes Mellitus • Type 2 Diabetes Mellitus • Venous Thromboembolism

Tenecteplase versus alteplase in patients with acute ischemic stroke: an updated systematic review and meta-analysis. (PubMed, Eur J Med Res) - "When compared with alteplase, 0.25 mg/kg tenecteplase is superior for achieving excellent functional outcomes and is not inferior in terms of major neurological improvement or death rates. TNKs at 0.25 mg/kg appear to be the optimal dose and a desirable alternative to alteplase."

Clinical • Journal • Retrospective data • Review • Cardiovascular • Ischemic stroke

TENECTEPLASE ADMINISTRATION LEADING TO ANGIOEDEMA (CHEST 2025) - No abstract available

Cardiovascular

RARE CASE OF INFERIOR MYOCARDIAL INFARCTION IMMEDIATELY AFTER TENECTEPLASE ADMINISTRATION FOR ACUTE ISCHEMIC STROKE (CHEST 2025) - No abstract available

Clinical • Cardiovascular • Ischemic stroke • Myocardial Infarction

Current Advancement and Patient Outcomes in Reperfusion Brain Injuries After Stroke: A Comparative Analysis of Thrombolysis and Thrombectomy. (PubMed, Brain Behav) - "The review underscores the need for precision medicine approaches, improved imaging for patient selection, and comprehensive longitudinal studies to optimize reperfusion strategies. Targeted interventions addressing oxidative damage and inflammation hold promise for reducing RBI and improving long-term patient outcomes."

Clinical • Journal • Review • Cardiovascular • CNS Disorders • Inflammation • Ischemic stroke • Vascular Neurology