Tenecteplase no longer 'off label' for acute ischemic stroke

The University of Cincinnati's Yasmin Aziz was featured in a MedCentral article discussing the recent FDA approval of the drug tenecteplase (TNK) for treatment of acute ischemic stroke.

Trials of alteplase, also called tPA, were pioneered at the University of Cincinnati in the late 1980s, representing the first proven treatment for ischemic stroke. TNK is a more recently developed clot-busting drug that can be administered in a single IV injection within seconds.

Aziz said many academic health centers and private institutions have been using TNK off label since data from the 2022 ACT trial was published.

While there are new dosing instructions associated with the FDA approval, Aziz said the speed of delivering TNK makes it appealing. Administering tPA requires a 1-minute infusion followed by a 60-minute infusion of the rest of the dosage, while TNK requires a 5-second infusion.

“I will tell you, the ease of use is really what’s going to get people to change," said Aziz, MD, director, Acute Stroke Trials; associate director, Vascular Neurology Fellowship; and assistant professor in the Department of Neurology and Rehabilitation Medicine in UC's College of Medicine; UC Health neurologist; director, NIH StrokeNet Digital Media; and co-investigator, NIH StrokeNet Ohio Valley Regional Coordinating Center.

“I think this will hopefully allow us to treat more patients faster with less chance of error,” she continued. “It’s much easier to give a drug like tenecteplase in a moving ambulance."

Read the MedCentral article.

Featured photo at top of illustration of brain with stroke symptoms. Photo/PeterSchreiber.media/iStock.