OBJECTIVE: To describe the pharmacology, pharmacokinetics, efficacy; and sa
fety of tenecteplase in reducing mortality associated with acute myocardial
infarction (AMI).
DATA SOURCES: Published articles were identified from MEDLINE (from 1966 to
December 2000) and Current Contents (all sections) searches.
STUDY SELECTION AND DATA EXTRACTION. Dose-ranging and pivotal studies were
included for analysis in the clinical trials section.
DATA SYNTHESIS: Tenecteplase is a third-generation thrombolytic indicated f
or the reduction of mortality associated with AMI. Tenecteplase has a longe
r half-life that allows for single-dose, intravenous bolus administration.
Data from clinical trials support that tenecteplase is similar to alteplase
in reducing 30-day mortality rates in patients who have had an AMI. In the
ASSENT-2 (Assessment of the Safety and Efficacy of a New Thrombolytic) tri
al, patients treated with tenecteplase required fewer blood transfusions an
d experienced fewer episodes of noncerebral bleeding compared with those tr
eated with alteplase.
CONCLUSIONS: Tenecteplase is an effective thrombolytic agent for the treatm
ent of AML It can be given as a single weight-based dose; however, it appea
rs to offer no significant advantage over other agents in terms of its effi
cacy or rate of intracranial hemorrhage.