Drug updated on 4/17/2024
| Dosage Form | Injection (intravenous: 50 mg, 100 mg) |
| Drug Class | Tissue plasminogen activator |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of Acute Ischemic Stroke (AIS).
- For the treatment of Acute Myocardial Infarction (AMI) to reduce mortality and incidence of heart failure.
- For the treatment of Acute Massive Pulmonary Embolism (PE) for lysis.
Summary
- Alteplase (Activase) is indicated for the treatment of Acute Ischemic Stroke (AIS), Acute Myocardial Infarction (AMI), and Acute Massive Pulmonary Embolism (PE).
- A total of 6 Systematic Reviews / Meta-Analyses were reviewed to gather information about this drug.
- In a comparison between intravenous tenecteplase and alteplase in patients with AIS, no significant differences were found in terms of functional outcome on the modified Rankin Scale, successful recanalization, early neurologic improvement within 48 hours, any intracranial hemorrhage or symptomatic ICH.
- Another study suggested that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase due its lower cost and ease of administration.
- Early anti-platelet therapy after administering alteplase did not show any benefit for acute ischemic stroke patients based on current evidence from randomized controlled trials conducted between January 2000 and April 2020.
- Orolingual angioedema occurred in approximately 1% of IVT-treated stroke patients who received altepalse; factors associated with this condition included previous treatment with ACE inhibitors, hypertension, diabetes dyslipidemia, and female sex according to one meta-analysis involving over five thousand participants across thirteen studies.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Activase (alteplase) Prescribing Information. | 2022 | Genentech, Inc. A Member of the Roche Group, South San Francisco, CA |
| Comparative efficacy and safety of tenecteplase and alteplase in acute ischemic stroke: a pairwise and network meta-analysis of randomized controlled trials. | 2022 | Journal of the Neurological Sciences |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| The efficacy and safety of intravenous thrombolysis with tenecteplase versus alteplase for acute ischemic stroke: a systematic review and meta-analysis. | 2023 | Neurological Sciences |
| Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review | 2022 | International Journal of Emergency Medicine |
| The safety and effectiveness of early anti-platelet therapy after alteplase for acute ischemic stroke: a meta-analysis. | 2021 | Journal of Clinical Neuroscience |
| Related factors with orolingual angioedema after intravenous alteplase in acute ischemic stroke: results from a single-center cohort and meta-analysis. | 2021 | Neurological Sciences |
| Safety and efficacy of repeated thrombolysis with alteplase in early recurrent ischemic stroke: a systematic review. | 2019 | Journal of Stroke & Cerebrovascular Diseases |
| Tenecteplase versus alteplase in acute ischemic stroke: systematic review and meta-analysis | 2018 | Acta Neurologica Belgica |