Thrombolysis With Single Bolus Tenecteplase Compared With Streptokinase Infusion in the Treatment of Acute Pulmonary Embolism

Patra, Soumya; Nagesh, CM; Reddy, Babu; Srinivas, B.C.; Manjunath, CN; Hegde, Madhav

doi:10.1177/1076029613511524

Cited by 8 publications

(11 citation statements)

References 16 publications

(20 reference statements)

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“…Four studies were RCTs ( 10 , 19 , 21 , 22 ), and two studies were retrospective/prospective cohort studies. ( 20 , 23 ) Among the six studies, only one study focused on high-risk PE, four RCT studies included patients with intermediate risk, and one study included both intermediate-risk and high-risk PE patients. ( 10 , 19 , 21 – 23 ) Doses of tenecteplase ranged from 30 to 50 mg (0.5 mg/kg), with a 5 mg step-up for every 10 kg increase from 60 to 90 kg.…”

Section: Resultsmentioning

confidence: 99%

“…( 20 , 23 ) Among the six studies, only one study focused on high-risk PE, four RCT studies included patients with intermediate risk, and one study included both intermediate-risk and high-risk PE patients. ( 10 , 19 , 21 – 23 ) Doses of tenecteplase ranged from 30 to 50 mg (0.5 mg/kg), with a 5 mg step-up for every 10 kg increase from 60 to 90 kg. All studies scored ≥4 by the Jadad scale or NOS score, where appropriate.…”

Section: Resultsmentioning

confidence: 99%

“…Among the five qualified studies for intermediate-risk PE, four studies were RCTs and one was a cohort study ( 10 , 19 , 21 – 23 ). Tenecteplase was used in all studies, combined with heparin in four studies and with LMWH in one study.…”

Section: Resultsmentioning

confidence: 99%

“…Meyer et al ( 10 ) collected data on the largest number of patients of 1,005, of whom 506 received tenecteplase. The study of Patra et al ( 23 ) was the only cohort study including both high- and intermediate-risk PE patients. Table 2 shows the baseline information of the patients included.…”

Section: Resultsmentioning

confidence: 99%

“…Many studies have been conducted on PE patients with tenecteplase, but results were inconsistent ( 10 , 19 – 23 ). Therefore, we aimed to summarize the efficacy and safety data of tenecteplase compared with anticoagulant therapy in patients with PE.…”

Section: Introductionmentioning

confidence: 99%

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Tenecteplase in Pulmonary Embolism Patients: A Meta-Analysis and Systematic Review

Zhang

et al. 2022

Front. Med.

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ObjectiveTo assess the efficacy and safety of tenecteplase in patients with pulmonary embolism (PE).MethodsWe completed the literature search on May 31, 2021 using PubMed, EMBASE and the Web of Science. Analyses were conducted according to PE risk stratification, study design and duration of follow-up. The pooled risk ratios (RRs) and its 95% confident intervals (CIs) for death and major bleeding were calculated using a random-effect model.ResultsA total of six studies, with four randomized controlled trials (RCTs) and two cohort studies, were included in this study out of the 160 studies retrieved. For patients with high-risk PE, tenecteplase increased 30-day survival rate (16% vs 6%; P = 0.005) and did not increase the incidence of bleeding (6% vs 5%; P = 0.73). For patients with intermediate-risk PE, four RCTs suggested that tenecteplase reduced right ventricular insufficiency at 24h early in the onset and the incidence of hemodynamic failure without affecting mortality in a short/long-term [<30 days RR = 0.83, 95% CI (0.47, 1.46);≥30 days RR = 1.04, 95% CI (0.88, 1.22)]. However, tenecteplase was associated with high bleeding risk [<30 days RR = 1.79, 95% CI (1.61, 2.00); ≥30 days RR = 1.28, 95% CI (0.62, 2.64)].ConclusionsTenecteplase may represent a promising candidate for patients with high risk PE. However, tenecteplase is not recommended for patients with intermediate-risk PE because of high bleeding risk. More large-scale studies focused on tenecteplase are still needed for PE patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tenecteplase in Pulmonary Embolism Patients: A Meta-Analysis and Systematic Review

Zhang

et al. 2022

Front. Med.

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Indications for Systemic Thrombolysis Over Anticoagulation

Stewart

Kline

2020

Pulmonary Embolism

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Association between 2D echocardiographic right atrial volume to left atrial volume (RAV/LAV) ratio and in-hospital prognosis in thrombolysed acute pulmonary thromboembolism patients

Kiran

Chandrasekhar

Ali

2020

Indian Heart Journal

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Right atrial volume/Left atrial volume (RAV/LAV) ratio is a good hemodynamic parameter in acute pulmonary thromboembolism (PTE), whose prognostic ability by 2D echocardiography is not studied to date. We conducted a 27 month, prospective observational study on 55 eligible acute PTE thrombolysed (29: Tenecteplase; 26: Streptokinase) patients. The primary endpoint was a composite of in-hospital death and poor right ventricular reverse remodelling at the time of discharge. The incidence of primary end-point and death were 40% and 7.2% respectively. On regression analysis, RAV/LAV ratio was the only predictor of the primary endpoint, with an optimal cut-off of 3.8 (accuracy 75%).

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Thrombolysis With Single Bolus Tenecteplase Compared With Streptokinase Infusion in the Treatment of Acute Pulmonary Embolism

Abstract: These results suggest that a 24-hour infusion regimen of STK is as effective as bolus TNK in the treatment of patients with APE in countries with limited resources.

Cited by 8 publications

References 16 publications

Tenecteplase in Pulmonary Embolism Patients: A Meta-Analysis and Systematic Review

Tenecteplase in Pulmonary Embolism Patients: A Meta-Analysis and Systematic Review

Indications for Systemic Thrombolysis Over Anticoagulation

Association between 2D echocardiographic right atrial volume to left atrial volume (RAV/LAV) ratio and in-hospital prognosis in thrombolysed acute pulmonary thromboembolism patients

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