Therapeutic effect of tenecteplase on treatment of cerebral arterial thrombosis: a meta-analysis

Y. Zang, J. Hou, L.-Y. Wang

Department of Neurology, 313^th Hospital of CPLA, Huludao, China. zhangyongzhy1@sina.com

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• Pharmacology

OBJECTIVE: To evaluate the clinical efficacy between tenecteplase (TNK) and alteplase (rt-PA). Furthermore, suitable dosage of TNK in cerebral arterial thrombosis treatment was explored.

MATERIALS AND METHODS: The studies met with the predefined selection criteria were selected for the present study. The quality of each study was evaluated by Cochrane quality evaluation. The outcome indexes including early major neurological improvement (MNI), excellent recovery, good recovery, recanalization at 24 hours-complete or partial, symptomatic intracranial hemorrhage, any parenchymal hematoma and deaths were analyzed by using RevMan and Stata statistical software, under a random-effects model or a fixed-effects model. The safety and efficacy between TNK and rt-PA were investigated. Furthermore, the clinical efficacy outcomes between different dosages of TNK were evaluated. Sensitivity analysis was performed to evaluate the reliability.

RESULTS: A total of 6 studies were enrolled for the present study. Compared with the 0.1 mg/kg TNK group, 0.25 mg/kg TNK group had a significantly better MNI (RR = 0.66, 95% CI: [0.49, 0.88], p = 0.005) and excellent recovery (RR = 0.71, 95% CI: [0.53, 0.95], p = 0.02). TNK group achieved an increased MNI (RR = 1.59, 95% CI: [1.08, 2.34], p = 0.02) and a reduced parenchymal hematoma (RR = 0.26, 95% CI: [0.10, 0.71], p = 0.009) than rt-PA group.

CONCLUSIONS: Compared with rt-PA, TNK could better improve the major neurological function. TNK 0.25 mg/kg had a better clinical treatment effect than TNK 0.1 mg/kg.

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