TENECTEPLASE AND ALTEPLASE IN ISCHEMIC STROKE: AN INTEGRATIVE REVIEW FROM 2019 TO 2024

Abstract

Acute ischemic stroke is one of the main neurological emergencies, and given the different medications available, it is necessary to know the main thrombolytics available in this scenario. The objective of this study was to compare data encompassing both the efficacy and adverse effects of alteplase and tenecteplase to discover a possible interchangeability between these drugs. Articles were searched in the PubMed and Virtual Health Library Brazil databases using the following descriptors: “thrombolytics”, “stroke”, “alteplase”, and “tenecteplase” using the Boolean operator “AND”. This integrative review included articles published from 2019 to October 2024, with full text, and belonging to one of the following study categories: clinical study, observational study, clinical trial, controlled clinical trial, and randomized controlled trial. Studies outside the proposed theme and duplicate studies were removed. Twenty-five studies were selected for analysis; twenty partially agreed with the possibility of prescribing tenecteplase, and five made negative observations, mainly regarding doses greater than 0.4 milligrams per kilogram or its administration after 4 hours and 30 minutes of evolution. It was concluded that the slight superiority of tenecteplase over alteplase in terms of efficacy and adverse effects does not have sufficient statistical significance to justify a change in treatment protocol.