THROMBOLYSIS: COMPARISON OF ALTEPLASE AND TENECTEPLASE IN ISCHEMIC STROKE

Abstract

This article sought to compare the efficacy and safety of tenecteplase versus alteplase, the main drug in the management of acute ischemic stroke, a stigmatizing disease and one of the greatest challenges for global public health due to its high morbidity, mortality, and incidence. The methodology employed was an integrative literature review of the Cochrane Library and PubMed databases, from which 27 clinical and randomized trials published between 2019 and 2024 were selected. The results consistently showed that tenecteplase was non-inferior to alteplase, maintaining an equivalent safety profile. Eighteen of these studies pointed to superiority, especially in the recanalization rate in large vessel occlusions, resulting in better functional outcomes at 90 days and a higher proportion of patients achieving functional independence. Cost-effectiveness analyses, in turn, suggested long-term savings. In conclusion, tenecteplase is an effective and safe alternative, with potential superiority in recanalization and functionality, representing a promising change in the standard of care for ischemic stroke.