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WSC 2023 | System-wide transition to tenecteplase use for ischemic stroke thrombolysis

Traditionally administered to treat myocardial infarction, tenecteplase is now gaining traction for its use in acute ischemic stroke treatment. In November 2022, Alberta, Canada, became the first region to transition from alteplase to tenecteplase for thrombolytic stroke therapy, as discussed in this video by Mary-Lou Halabi, MScOT, Alberta Health Services, Edmonton, Alberta, Canada, and Michael D. Hill, MD, University of Calgary, Alberta, Canada. Dr. Hill references the AcT (NCT03889249) and ATTEST (NCT01472926) trials as evidence for the non-inferiority of tenecteplase compared to alteplase. Due to its easier administration, this was enough to influence a transition. Ms. Halabi details the logistical considerations, including the approval process, strategic distribution, and healthcare professional education. Dosing disparities between stroke and cardiac applications necessitate vigilant safety monitoring to prevent adverse events due to dosing errors. This interview took place at the World Stroke Congress (WSC) 2023 in Toronto, Canada.

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Michael Hill reports the following disclosures: I am the medical director for stroke the Alberta Health Services Strategic Clinical Network. I was a co-investigator on the ACT trial which was funded by the Canadian Institutes for Health Research. We have grants from Hoffman-LaRoche Canada, Genetech LLC and Boehringer-Ingelheim to the University of Calgary for various clinical trials that we are leading.