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

Effect of Intravenous Tirofiban Versus Placebo on Excellent Outcome in Patients With Acute Ischemic Stroke: The Multicenter, Randomized INSTANT Trial Protocol. (PubMed, J Am Heart Assoc) - P=N/A | "The INSTANT trial was designed to determine the role of tirofiban within 24 hours after IVT in patients with acute ischemic stroke. Our primary objective is to investigate whether the early administration of tirofiban following IVT can enhance the proportion of patients exhibiting no or minimal symptoms post acute ischemic stroke."

Journal • Atrial Fibrillation • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Ischemic stroke

Safety and real-world effectiveness in the transition from Alteplase to Tenecteplase for stroke treatment. (PubMed, Can J Neurol Sci) - No abstract available

Journal • Real-world evidence • Cardiovascular

Tenecteplase: expanding horizons in thrombolytic therapy across various clinical indications. (PubMed, Heart) - "Meta-analysis of randomised trials demonstrated superiority of tenecteplase over alteplase in achieving excellent functional outcome after stroke (no disability). The practical advantages of bolus administration and having a single thrombolytic on formulary for all relevant indications have positioned tenecteplase as the leading thrombolytic agent in current practice. This review discusses the current evidence and treatment guidelines in this rapidly evolving field."

Journal • Review • Cardiovascular • Ischemic stroke • Myocardial Infarction • Pulmonary Embolism • Respiratory Diseases

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

The efficacy and safety of tenecteplase versus alteplase in patients with myocardial infarction: a systematic review (ESC-WCC 2025) - No abstract available

Clinical • Review • Cardiovascular • Myocardial Infarction

Rescue Thrombolysis for Medium Vessel Occlusion (RESCUE-TNK) (clinicaltrials.gov) - P2/3 | N=80 | Completed | Sponsor: General Hospital of Shenyang Military Region | Recruiting ➔ Completed | Trial completion date: Sep 2025 ➔ Jun 2025 | Trial primary completion date: Sep 2025 ➔ Jun 2025

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

Improvement in Microfluidic Patency with Von Willebrand Factor Aptamer in Ischemic Stroke Patients (ISTH 2025) - "BB-031 treatment 3 hours post-occlusion increased outflow 0.951±1.279g compared to 0.156±0.266g with vehicle, 0.487±0.597g with Alteplase, and 0.249±0.328g with Tenecteplase (mean±SD). In stroke patient samples, BB-031 significantly increased outflow compared to vehicle(p<0.05)(Fig2A-B). Table or Figure Upload"

Clinical • Cardiovascular • Hematological Disorders • Ischemic stroke • Thrombosis • ITGA2B

Investigating thrombolytic therapies in a model of embolising coronary microvascular obstruction (ISTH 2025) - "Aims We investigated whether CoFI with concentrated microdoses of alteplase, tenecteplase or tirofiban can induce thrombolysis of human microthrombi in an in vitro microfluidic model of MVO. Repeating a 60-second tirofiban treatment three times with 2-miunte intervals between treatments significantly increased thrombolysis to 40% (p < 0.05). Tirofiban and alteplase combined demonstrated no additional benefit on thrombolysis compared to alteplase alone."

Cardiovascular • Myocardial Infarction

DNase I unlocks the thrombolytic potential of intravenously-administered tPA (ISTH 2025) - "A non-significant trend towards increased thrombolysis was observed in tenecteplase- vs actilyse-treated patients. Analysis of the impact of DNase 1 on thrombi showed that DNase 1 induced fibrinolysis and plasmin inhibitors release, suggesting that extracellular DNA contributes to intrathrombus retention of fibrinolysis inhibitors"

Cardiovascular • Ischemic stroke • Thrombosis

Halo fluorescence fibrinolysis test: a novel quantitative assay to evaluate fibrinolysis on established plasma clots. (PubMed, Res Pract Thromb Haemost) - "Fibrinolysis was induced with tissue-type plasminogen activator or its variant tenecteplase, and clot breakdown was monitored via real-time fluorescence detection by a microplate reader. Furthermore, the test distinguished fibrinolysis from plasmin generation, demonstrated by the differential effects of tranexamic acid inhibition. The HoFF test offers a sensitive, reliable, and high-throughput tool for quantitatively evaluating fibrinolysis on established human and mouse plasma and whole blood clots."

Journal • Thrombosis

Fibrinogen time course in acute ischemic stroke patients treated with intravenous thrombolysis with alteplase or tenecteplase. (PubMed, Eur Stroke J) - "Fibrinogen depletion was observed only in AIS patients receiving alteplase and was associated with numerically higher rates of major hemorrhagic complications. These findings require independent confirmation in larger, international cohort studies."

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

Incidence of significant adverse events within 24 h following administration of tenecteplase or alteplase for treatment of acute ischemic stroke: A multi-center, single-enterprise, retrospective study. (PubMed, Am J Emerg Med) - "No statistical difference was observed in the primary composite outcome when treated with tenecteplase and alteplase for AIS treatment. There was no observed safety risk between tenecteplase and alteplase in patients treated for AIS at CCHS in Florida and Ohio."

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

Concomitant systemic thrombolytic therapy with tissue plasminogen activator for acute pulmonary embolism: a systematic review and meta-analysis. (PubMed, Expert Rev Cardiovasc Ther) - "Subgroup analysis based on the type oftPA used showed similar results except for the significantly lower major-bleedingwith alteplase compared to tenecteplase (p = 0.003) and a lower incidence ofbleeding events with low dosage while maintaining relatively similar treatmentefficacy. Notably, mortality reduction lost statistical-significance uponexcluding non-randomized trials and trials with baseline imbalances. This paper was registered on PROSPERO (CRD42024553660)."

Journal • Retrospective data • Review • Cardiovascular • Pulmonary Embolism • Respiratory Diseases

Tenecteplase in Central Retinal Artery Occlusion Study (TenCRAOS): Protocol for a randomized-controlled trial. (PubMed, Eur Stroke J) - "TenCRAOS intends to assess the efficacy and safety of systemic TNK within 4.5 h of CRAO onset."

Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Ischemic stroke • Ophthalmology • Retinal Disorders

Adjunctive intra-arterial thrombolysis after successful endovascular thrombectomy for large vessel occlusion: Meta-analysis of outcomes, dosage, and patient selection. (PubMed, J Neurointerv Surg) - "Adjunctive IA thrombolysis following successful EVT may improve functional outcomes without added risk of sICH. Certain patient subgroups (those with lower recanalization rates, higher NIHSS, and cardioembolic etiology) and specific thrombolytic agents and dosages (alteplase 0.225 mg/kg, tenecteplase 0.125 mg/kg) appear to derive greater benefits from this approach. Further research is needed to validate these findings and refine patient selection."

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

Effect of Time Delay on Reperfusion After Tenecteplase in an Extended Time Window: Analysis From the CHABLIS-T Trials. (PubMed, J Am Heart Assoc) - P2 | "Time delay was associated with reduced postthrombolytic reperfusion odds in patients with stroke treated with tenecteplase, especially in nonatherosclerotic cases. Prompt reperfusion remains essential, even in patients with benign perfusion profiles in an extended time window."

Journal • Cardiovascular • Ischemic stroke

Tenecteplase Beyond 4.5 Hours in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. (PubMed, J Stroke) - "This meta-analysis suggests TNK might be safe and effective for selected AIS patients in the 4.5- to 24-hour time window, offering improved functional outcomes without a significant increase in hemorrhagic complications."

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

Tenecteplase for treatment of acute ischemic stroke in the extended time window, a review of current data (CNSF 2025) - No abstract available

Review • CNS Disorders

Cost-effectiveness of tenecteplase compared to alteplase for acute ischemic stroke from a Canadian perspective (CNSF 2025) - No abstract available

Cost effectiveness • HEOR • CNS Disorders

Letter to the editor, regarding "Transition from alteplase to tenecteplase for treatment of acute ischemic stroke in a rural stroke network of the Midwest: Planning, execution, safety, and outcomes" recently published by Loggini. (PubMed, Clin Neurol Neurosurg) - No abstract available

Journal • Cardiovascular • Ischemic stroke

Intravenous Thrombolysis with Tenecteplase in Mild Stroke Patients: A Multi-center, Real - World Cohort Study (ChiCTR) - P4 | N=2472 | Recruiting | Sponsor: Xiangyang First People’s Hospital Affiliated to Hubei University of Medicine; Xiangyang First People’s Hospital Affiliated to Hubei University of

New P4 trial • Cardiovascular • CNS Disorders • Vascular Neurology

Intravenous Tenecteplase (TNK) in Acute Ischemic Stroke: a multicenter, prospective registry (ChiCTR) - P4 | N=2396 | Recruiting | Sponsor: Beijing Daxing District People’s Hospital; Beijing Daxing District People’s Hospital

New P4 trial • Cardiovascular • Ischemic stroke

Safety and efficacy of adjunctive intra-arterial Tenecteplase after successful endovascular thrombectomy in patients with large vessel occlusion stroke (ChiCTR) - P=N/A | N=498 | Recruiting | Sponsor: The 2nd Affiliated Hospital of Chongqing Medical University; The 2nd Affiliated Hospital of Chongqing Medical University

New trial • Cardiovascular

STEPS1: Stereotactic Aspiration with Tenecteplase for Supratentorial Intracerebral Hemorrhage (ChiCTR) - P=N/A | N=9 | Not yet recruiting | Sponsor: Tongji Hospital, Tongji Medical College ,Huazhong University of Science and Technology; Tongji Hospital, Tongji Medical College ,Huazhong University o | Phase classification: P1 ➔ P=N/A

Phase classification • Cerebral Hemorrhage • Hematological Disorders

Stroke thrombectomy of a mural thrombus in a severe dolichoectatic basilar artery with double parallel large stent retrievers and Sofia 88. (PubMed, J Neurointerv Surg) - "We present the case of an older adult with severe acute ischemic stroke caused by a mid-basilar posterior wall mural thrombus within a markedly dolichoectatic basilar artery (diameter >10 mm, length >40 mm, suprasellar extension >15 mm).1-3 Following intravenous tenecteplase, mechanical thrombectomy was attempted using a single 6.5 mm stent retriever with aspiration via a Sofia 88 catheter, but failed to achieve sufficient recanalization...The patient demonstrated rapid clinical recovery. This case highlights a practical salvage technique for thrombus removal in severe basilar dolichoectasia, emphasizing the need for tailored thrombectomy strategies in nonstandard vascular anatomies.neurintsurg;jnis-2025-023562v1/V1F1V1Video 1 ."

Journal • Cardiovascular • CNS Disorders • Ischemic stroke • Thrombosis