Novas drogas no manejo do acidente vascular encefálico isquêmico: Uma comparação do uso de tenecteplase e alteplase

Abstract

Introduction: Ischemic stroke affects thousands of people annually and inflicts great morbidity and mortality on affected patients. Standard treatment consists of the administration of alteplase. However, this medication faces some challenges. New drugs have been tested in the management of this condition, in order to reduce its impacts, as is the case with tenecteplase, which was presented as an alternative for this purpose. Objective: Therefore, this research aims to analyze and compare the results of the use of tenecteplase and alteplase, and point out the main obstacles faced in the management of stroke. Methodology: This is an integrative literature review carried out on the research platforms of the Virtual Health Library, SciELO and PubMed. 220 publications were found between 2019 and 2024, in any language, with the descriptors “Tenecteplase” and “Acidente Vascular Encephalico”. Of these, 23 were chosen to be part of this study. Results and Discussion: Tenecteplase, when compared with alteplase, showed successful results more frequently in early recanalization and better results on the modified Rankin scale at 90 days. The mortality rate between the two medications was similar, with no statistical difference in most studies, although some showed that tenecteplase reduced all-cause mortality. The rates of symptomatic intracranial hemorrhage did not register a considerable difference. Tenecteplase was shown to be safe and non-inferior to alteplase. Conclusion: Tenecteplase represents a significant advance in the treatment of ischemic stroke. Since it has the same properties as the gold standard drug, it proved to be as safe and effective as the same and has dosage advantages in relation to it. More studies need to be done in order to establish the use of tenecteplase as an alternative to alteplase in selected patients.