Summary

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• Tenecteplase (TNKase) is indicated to reduce the risk of death associated with acute ST elevation myocardial infarction (STEMI).
• Information was derived from 15 systematic reviews and meta-analyses.
• Both tenecteplase and alteplase show comparable outcomes in improving clinical endpoints such as early neurological improvement, excellent functional outcome, and recanalization rates post-treatment in AIS patients.
• The effectiveness of tenecteplase appears dose-dependent, with the 0.25 mg/kg dosage frequently cited as potentially more efficacious compared to alteplase in achieving excellent functional outcomes at three months.
• Studies report no significant differences between tenecteplase and alteplase in terms of safety outcomes like symptomatic intracranial hemorrhage and mortality rates.
• In patients presenting with acute tandem occlusions, tenecteplase's safety and efficacy were comparable to alteplase; however, incidents of any intracranial hemorrhage were more frequent with tenecteplase.
• Synthesized evidence suggests that tenecteplase offers a viable alternative to alteplase for treatment within 4.5 hours of symptom onset due to its pharmacokinetic profile, favoring single bolus administration, which might offer logistical benefits over alteplase.
• Tenecteplase stands out as a promising agent, mirroring or surpassing alteplase under certain clinical scenarios, emphasizing the importance of an optimal dosing strategy.