Tenecteplase shows modest benefit for late stroke treatment

For people who wake up with a stroke or arrive at the hospital late, every minute counts. A large review of 4,000 adults treated beyond the usual 4.5-hour window looked at a clot-busting drug called tenecteplase. The study found a modest increase in excellent and favorable recovery at 90 days. But it also found a significantly higher risk of serious bleeding in the brain. The drug did not change the risk of death. This analysis combined data from multiple studies, so the results are more reliable than any single trial. The findings suggest tenecteplase can help some patients, but only with careful imaging to select those most likely to benefit and least likely to bleed. The certainty of the evidence was high for recovery and death, and moderate for bleeding risk. The review did not report specific patient counts or how long each study lasted.