A randomised controlled drug trial suggests clot-busting drug Tenecteplase provides better outcomes for stroke patients compared to the current standard of care alteplase.  

Researchers from the Royal Melbourne Hospital (RMH) have compared pre-hospital treatment administering tenecteplase against the gold-standard alteplase in patients on the Melbourne Mobile Stroke Unit (MSU).

Led by Stroke Neuroimaging Lab Head at the RMH and University of Melbourne, Associate Professor Andrew Bivard said treatment with tenecteplase resulted in early clinical improvement and can also be administered significantly faster, which is key when treating stroke patients.

“The trial showed that patients treated with tenecteplase had a significantly higher chance of ultra-early clinical improvement on their way to hospital,” he said.

Tenecteplase is administered through a single dose compared to a one-hour infusion required for alteplase.

“This trial combines Australia’s only stroke ambulance with a much more effective acute treatment to provide the optimal model of care,” A/Prof Bivard said.

Treatment and patient outcomes for acute ischaemic stroke are highly time dependent.

The Melbourne MSU – run by the RMH and Ambulance Victoria contains a portable CT brain scanner, an essential tool in the diagnosis of stroke, and takes clinicians to the patient to provide pre-hospital treatment.

The results of the tenecteplase trial were presented at the European Stroke Organisation Conference (ESOC) in Lyon, France on Wednesday 4 May 2022.

This work was made possible with support from the Melbourne Academic Centre for Health through the Australian Government’s Medical Research Future Fund (MRFF).

Mobile Stroke Unit with Ambulance Victoria paramedic and the RMH Stroke team
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