5PSQ-075 Efficacy and patient-reported outcomes of tenecteplase and alteplase in acute stroke management: a comparative analysis

<h3>Background and Importance</h3> Acute ischaemic stroke is a leading cause of disability and mortality worldwide, with timely thrombolytic therapy being crucial for improving outcomes. Two commonly used thrombolytic agents are tenecteplase and alteplase. <h3>Aim and Objectives</h3> Comparison of the quality of life and survival rates of patients treated with tenecteplase with alteplase at a tertiary care hospital after an acute ischaemic stroke. <h3>Material and Methods</h3> A retrospective observational study was conducted, reviewing data from patients admitted with ischaemic stroke and treated with either tenecteplase or alteplase at a tertiary care hospital over a 1 year period (January 2022 to December 2022). Primary outcome measures were survival rates and quality of life scores at 30- and 90-days post-treatment. Secondary outcome measures included rates of symptomatic intracranial haemorrhage (sICH), vascular reocclusion, length of hospital stay, and discharge destination. Quality of life was assessed using the EuroQol-5D questionnaire. <h3>Results</h3> Fifty-four patients were included (67.2% male), with a median age of 62 years (range 21–79). Tenecteplase was administered to 12.96% of the patients, while the remaining 88.52% received alteplase. No significant differences were observed in survival rates between the tenecteplase and alteplase groups at 30 (85.71% vs 83.74%) and 90 days post-treatment (71.42% vs 69.4%). However, there was a significant difference in quality of life scores, with the tenecteplase group achieving higher scores (0.53 ± 0.14 vs 0.41 ± 0.03 and 0.76 ± 0.08 vs 0.60 ± 0.03 at 30 and 90 days, respectively, where 0 and 1 represent the worst and best possible health states, respectively). No significant differences were found in sICH rates (14.29% vs 11.42% for tenecteplase and alteplase, respectively) or vascular reocclusion rates (14.29% vs 12.76%). Length of hospital stay was not statistically significant (8.2 ± 3.6 vs 9.3 ± 3.1 days), although a higher percentage of patients in the tenecteplase group were discharged home or to rehabilitation centres (85.71% vs 79.09%). <h3>Conclusion and Relevance</h3> The analysed results suggest that tenecteplase is non-inferior to alteplase in terms of efficacy for the treatment of acute ischaemic stroke, with a potential advantage in quality of life outcomes. These findings correlate with those published in the ATTEST and NOR-TEST trials. However, further studies are needed to confirm these results in clinical practice. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest