| Title: |
Thrombolysis With Tenecteplase for Minor Disabling Stroke |
| Authors: |
Zhang, Yiran; Buck, Brian H; Barber, Philip A; Chatterjee, Kausik; Clarke, Brian; Choi, Philip MC; Hunter, Gary; Ganesh, Aravind; Mishra, Sachin M; Williams, David; Campbell, Bruce CV; Dowlatshahi, Dar; Butcher, Ken S; Krishnan, Kailash; Wiggam, M Ivan; Kleinig, Timothy J; Muir, Keith W; Zerna, Charlotte; Field, Thalia S; Goyal, Mayank; Yu, Amy YX; Roffe, Christine; Demchuck, Andrew M; Parsons, Mark W; Bazan, Rodrigo; Ankolekar, Sandeep; Kennedy, James; Menon, Bijoy K; Mandzia, Jennifer L; Pille, Arthur; Kelly, Peter J; Marko, Martha; Singh, Nishita; Vatanpour, Shabnam; Lima, Fabrico O; Catanese, Luciana; Horn, MacKenzie; Ghia, Darshan; Ferrari, Julia; Greisenegger, Stefen; Hill, Michael D; Coutts, Shelagh B; Salluzzi, Marina; Blenkin, Nicole; Dueck, Ashley; Doram, Craig; Zhang, Qiao; Kenney, Carol; Ryckborst, Karla; Bohn, Shelly; Collier, Quentin; Taylor, Frances; Lethebe, B Cord; Molina, Carlos; Hart, Robert G; Kent, David; Martin, Renee H; Whiteley, William; Jambula, Anitha; Sage, Kayla; Toussaint, Lana; Save, Supriya; Lee, Julian; Laham, Nesreen; Sultan, Abdulaziz; Moussaddy, Aimen; Deepak, Akshay; Sitaram, Amith; Lockey, Andrew; Micielli, Andrew; Wadhwa, Ankur; Arabambi, Babawale; Graham, Brett; Tham, Carol; Bogiatzi, Chrysi; Doshi, Darshan; Chakraborty, Debabrata; Kim, Diana; Vasquez, Diego; Singh, Dilip; Tse, Dominic; Harrison, Emma; Smith, Elliott; Teleg, Ericka; Klourfeld, Evgenia; Klein, Gary; Sebastian, Ivy; Evans, James; Hegedus, Janka; Kromm, Julie; Lin, Katie; Ignacio, Katrina; Ghavami, Kimia; Ismail, Madawi; Moores, Margaret; Panzini, Marie-Andre; Boyko, Matthew; Almekhlafi, Mohammed; Newcommon, Nancy; Maraj, Nicholas; Imoukhuede, Oje; Volny, Ondrej; Stys, Peter; Couillard, Philippe; Ojha, Piyush; Eswaradass, Prasanna; Joundi, Raed; Appireddy, Ramana; Singh, Ravinder; Asuncion, Ria; Muir, Ryan; Dey, Sadanand; Mansoor, Salman; Wasyliw, Sanchea; Nagendra, Shashank; Hu, Sherry; Althubait, Shorog; Chen, Siew; Bal, Simerpreet; Gaal, Stephen; Peters, Steven; Ray, Sucharita; Chaturvedi, Surbhi; Subramaniam, Suresh; Fu, Vivian; Villaluna, Karina; Maclean, Genoveva; King-Azote, Princess; Ma, Carson; Plecash, Alyson; Murphy, Colleen; Gorman, Johnathon; Wilson, Laura; Zhou, Lily; Benavente, Oscar; Teal, Philip; Yip, Samuel; Mann, Sharan; Dewar, Brian; Demetroff, Michele; Shamloul, Rany; Beardshaw, Rebeccah; Roberts, Sohail; Blaquiere, Dylan; Stotts, Grant; Shamy, Michel; Bereznyakova, Olena; Fahed, Robert; Alesefir, Walid; Camden, Marie-Christine; Lavoie, Suzy; Hache, Annette; Collard, Karine; Mackey, Ariane; Gosselin-Lefebvre, Stephanie; Verreault, Steve; Beauchamp, Beth; Lambourn, Lindsay; Khaw, Alexander; Mai, Lauren; Sposato, Luciano; Bullrich, Maria Bres; Azarpazhooh, Reza; Fridman, Sebastian; Kapoor, Arunima; Southwell, Alisia; Bardi, Edith; Fatakdawala, Idris; Kamra, Maneesha; Lopes, Kaitlyn; Popel, Najla; Norouzi, Vanessa; Liu, Anna; Liddy, Anne; Ghoari, Bismah; Hawkes, Christine; Enriquez, Claire; Gladstone, David; Manosalva Alzate, HA; Khosravani, Houman; Hopyan, Julia; Sivakumar, Keith; Son, Maksim; Boulos, Mark; AlHamind, May; Swartz, Richard; Murphy, Robert; Reiter, Stephanie; Fitzpatrick, Tess; Bhandari, Vinaya; Penn, Andrew; Good, Jennifer; Penn, Melanie; Naylor, Melissa; Frost, Sheilah; Casaubon, Leanne; Cayley, Anne; Akthar, Farhana; Williams, Janice; Kalman, Libby; Crellin, Lisa; Wiegner, Relu; Singh, Shoba; Stewart, Tim; To, William; Pikula, Aleksandra; Jaigobin, Cheryl; Carpani, Frederico; Silver, Frank; Janssen, Helena; Schaafsma, Joanna; del Campo, Martin; Alskaini, Mohammed; Rajendram, Phavalan; Fairall, Paige; Granfield, Bonny; Crawford, Danna; Jabs, Juline; White, Leah; Sivakumar, Leka; Piquette, Lori; Nguyen, Thao; Nomani, Ali; Wagner, Amy; Alrohimi, Anas; Butt, Asif; D'Souza, Atlantic; Gajurel, Bikram; Vekhande, Chetan; Kamble, Harsha; Kalashyan, Hayrapet; Lloret, Mar; Benguzzi, Mowad; Arsalan, Nazeem; Ishaque, Noman; Ashayeriahmadabad, Rezan; Samiento, Robert; Hosseini, Seyed; Kazi, Sharish; Das, Shubhabrata; Sugumar, Tripthi; Zafar, Atif; Selchen, Daniel; Kostyrko, Pawel; Muccilli, Alexandra; Saposnik, Gustavo; Vandervelde, Cheyanne; Ratnayake, Kanchana; McMillan, Sue; Katsanos, Aristeidis; Shoamanesh, Ashkan; Sahlas, Demetrios; Medvedev, George; Naidoo, Vishaya; Todorov, Vesselin; Toma, Hassanain; Brar, Jaskiran; Horton, Myles; Shand, Elaine; Weatherby, Sandy; Jin, Albert; Durafourt, Bryce; Jalini, Shirin; Gardner, Aaron; Tyson, Cassandra; Junk, Emily; Foster, Kaitlyn; Bolt, Kala; Sylvain, Nicole; Maley, Sharleen; Urroz, Lilian; Peeling, Lissa; Kelly, Michael; Whelan, Ruth; Cooley, Regan; Teitelbaum, Jeanne; Boutayeb, Achraf; Moore, Angela; Cole, Erin; Waxman, Lindsay; Ben-Amor, Nadia; Sanchez, Rick; Khalil, Salma; Nehme, Ahmad; Legault, Catherine; Tampieri, Donatella; Ehrensperger, Eric; Vieira, Lucy; Cortes, Maria; Angle, Michael; Hannouche, Mathew; Badawy, Mohamed; Werner, Karin; Wieszmuellner, Sonja; Langer, Agnes; Gisold, Anna; Zach, Heidemarie; Rommer, Paulus; Macher, Stefan; Blechinger, Stephan; Marik, Wolfgang; Series, Wolfgang; Baumgartinger, Melanie; Krebs, Stefan; Strbian, Daniel; Koski, Jaana; Eirola, Saija; Ivanoff, Terhi; Erakanto, Anu; Kupari, Laura-Leena; Sibolt, Gerli; Panula, Jonatan; Tomppo, Liisa; Tiainen, Marjaana; Ahlstrom, Matti; Majander, N Martinez; Suomalainen, Olli; Raty, Silja; Levi, Christopher; Spratt, Neil; Kerr, Enda; Allen, Joanne; Kaauwai, Lara; Belevski, Linda; Russell, Michelle; Ormond, Sally; Chew, Alvin; Loiselle, Andre; Royan, Angela; Hughes, Bridget; Esperon, C Garcia; Pepper, Elizabeth; Miteff, Ferdi; He, Jiacheng; Lycett, Mitchell; Min, Myintzu; Murray, Natalia; Pavey, Nathan; de Barros, R Starling; Gangadharan, Shyam; Dunkerton, Sophie; Waller, Sophie; Sanchez, T Canento; Wellings, Tom; Edmonds, Gillian; Whittaker, Kerri-Ann; Ewing, Megan; Lee, Phoebe; Singkang, Rowena; McDonald, Amy; Santos, Angela; Shin, Christine; Jackson, David; Tsoleridis, Jessica; Fisicchia, Laura; Parsons, Nicola; Shenoy, Nikitha; Smith, Shannon; Sharobeam, Angelos; Balabanski, Anna; Park, Ashley; Williams, Cameron; Pavlin-Premri, Davor; Rodrigues, Edrich; Alemseged, Fana; Ng, Felix; Zhao, Henry; Beharry, James; Ng, Jo-Lyn; Williamson, John; Wong, Joseph; Li, Kenny; Kwan, Michael; Valente, Michael; Yassi, Nawaf; Yogendrakumar, Vignan; McNamara, Bailey; Buchanan, Claire; McCarthy, Claire; Thomas, Grace; Stephens, Karen; Chung, Mang; Tang, Melissa; Pachani, Naila; Stuart, Narelle; Lee, Rose; Frost, Tanya; Busch, Tessa; Menon, Ashwathi; Borojevic, Branko; Linton, Casey; Callaly, Edward; Garcia, Gayle; Dewey, Helen; Liu, Jennifer; Chen, Jessie; Nowak, Kara; To, Kien; Lizak, Nathaniel; Bhalala, Oneil; Park, Peter; Tan, Peter; Martins, Rodrigo; Cody, Ross; Forbes, Ryan; Tu, Steven; Ooi, Suyi; Dang, Yew; Ling, Zhi; Cranefield, Jennifer; Drew, Roy; Tan, Aaron; Kurunawai, Craig; Harvey, Jackson; Mahadevan, Joshua; Cagi, Lavenia; Palanikumar, Logesh; Chia, Nicholas; Goh, Rudy; El-Masri, Shaddy; Bailey, Peter; Urbi, Berzenn; Rapier, Cheryl; Berrill, Haylee; McEvoy, Helen; Dunning, Rachael; Kuriakose, Sumole; Chad, Terry; Sapaen, Vincent; Sabet, Arman; Shah, Darshan; Yeow, Dennis; Lilley, Kate; Ward, Kayla; Mahizhnan, M Mozhy; Tan, Meng; Lynch, Catherine; Coveney, Sarah; Tobin, Katrina; McCabe, John; Marnane, Michael; Murphy, Stephen; Large, Margaret; Moynihan, Barry; Boyle, Karl; Sanjuan, Estela; Sanchis, Mireia; Pancorbo, Olalla; Sala, Victoria; Garcia, Lidia; Garcia-Tornel, Alvaro; Juega, Jesus; Pagola, Jorge; Santana, Katherine; Requena, Manuel; Muchada, Marian; Olive, Marta; Rubiera, Marta; Deck, Matias; Rodriguez, Noelia; Lozano, Prudencio; Boned, Sandra; Arenillas, Juan F; Gomez, Beatriz; Munoz, FJ Reyes; Gomez, Alicia; Sanz, Ana; Garcia, Elisa; Penacoba, Gonzalo; Ramos, Maria; Alfonso, M de Lera; Leal, Joaquin; Feliu, Anna; Pardo, Laura; Ramirez, Paula; Murillo Hernandez, Alan; Dominguez, D Lopez; Rodriguez, Juan; Izaga, M Terceno; Reina, Montse; Viturro, Saima; Bojaryn, Urszula; molina, Victor Vera; Blas, Yolanda Silva; Siew, Rachel; Agustin, Sherwin; Seet, Christopher; Tu, Tianming; Murray, Alicia; Welch, Angela; Hatherley, Kim; Day, Nicola; Smith, Wilma; MacRae, Emma; Mitchell, Shirley; Mahmood, Ammad; Elliot, Jennifer; Neilson, Sam; Biswas, Viveka; Brown, Cameron; Simister, Robert; Lewis, Alexandra; Ashton, Amy; Black, Anna; Robinson, Anna; Williams, Annick; Banaras, Azra; Cahoy, Cyrille; Raingold, Georgia; Marinescu, Marilena; Atang, Ndifreke; Bason, Nina; Francia, Nina; Muhammad, Riham; Obarey, Sabaa; Feerick, Shez; Lee, Yee-Chin; Werring, David; Perry, Richard; Joseph, Jeethu; Benjamin, Jithen; Quinn, Lauren; Jhoots, Monica; Teal, Rachel; Ford, Gary; Harston, George; Bains, Harjit; Gbinigie, Ivie; Mathieson, Philip; Irons, Robert; Schulz, Ursula; Sim, Cai; Hayter, Elizabeth; Kennedy, Kate; Binnie, Lauren; Priestley, Naomi; Williams, Rebecca; Ghatala, Rita; Stratton, Sarah; Blight, Adrian; Zhang, Liqun; Davies, Angela; Duffy, Heather; Roberts, Jean; Homer, John; Roberts, Karen; Dodd, Kate; Cawley, Kathryn; Martin, Michaela; Leason, Sandra; Cotgreave, Susan; Taylor, Tom; Nallasivan, Arumugam; Haider, Syed; Chakraborty, Tapas; Webster, Tim; Halse, Omid; Gil, Ana; Martin, Barry; Joseph, Biji; Cabrera, Christine; Jose, Divia; Man, Jackie; Aquino, Jasmin; Sebastian, Leony; Osterdahl, Marc; Matthew, Mini; Ike, Naomi; Bello, Peter; Wilding, Peter; Fuentes, Rodel; Shah, Rupal; Mashate, Sheila; Patel, Tulsi; Nwanguma, Uchechi; Dave, Vaishali; El-Masry, Ahmed; Sheikh, Ambreen; Dawson, Angelo; Haber, Anna; Lee, Annabelle; O’Sullivan, Anthony; Drumm, Brian; O’Hare, Catherine; Roberts, Danielle; Kalladka, Dheeraj; Taylor, Eleanor; Rounis, Elisabeth; Vonberg, Frederick; Jenkins, Ieuan; Blagojevic, Jelena; George, Jithin; Kwan, Joseph; Saeed, Mamoun; Evans, Matthew; Haji-Coll, Michael; Tsuda, Miho; Sayed, Mohamed; Thanbirajah, Narmathey; Winterkron, Nicholas; Raha, Oishik; Vittay, Orsolya; Karim, Rabail; Smail, Ruaridh; Gauhar, Sabaa; Kalam, Sabrina; Elmamoun, Salwa; Malani, Sangam; Kelavkar, S Pralhad; Jamil, Sohaa; Auger, Stephen; Matar, Tarek; Hiden, Joanne; Varquez, Resti; Ferdinand, Phillip; Sanyal, Ranjan; Smith, Bernie; Okechukwu, Chidiogo; Fox, Elieen; Collins, Erin; Courtney, Kerry; Tauro, Suzanne; Patterson, Cathy; McShane, David; Roberts, Gerallt; McIImoyle, Jim; McGuire, Karen; Fearon, Patricia; Gordon, Patricia; Willmot, Mark; Isaacs, Karen; Lucas, Katherine; Smith, Linda; Dews, Lucie; Bates, Michelle; Lawrence, Stacey; Heeley, Susan; Patel, Vruti; Chin, Yin; Sims, Don; Littleton, Edward; Khaira, Jattinder; Nadar, Kurdow; Kieliszkowska, Agnieszka; Sari, Beatrix; Belo, Caroline Domingos; Manolo, Erika; Aeron-Thomas, John; Doheny, Maria; Pardo, M Garcia; Recaman, Maria; Tibajia, Maria; Aissa, Myriam; Bayhonan, Samantha; Conway, Staci; Bhalla, Ajay; Engineer, Anushka; Nouvakis, Dimitrios; Theochari, Evangelia; Boyle, Frederick; Teo, James; King-Robson, Josh; Law, Kar; Sztriha, Laszlo; Benger, Matthew; Farag, Mena; Williams, Owain; Alsukhni, Rana; Heller, Simon; Meenakshisundaram, Sreenivas; Yu, Tony; Mah, Yee; Zachariah, George; McGovern, Alex; Iqbal, Arshi; Day, Diana; Mitchell-Douglas, Jennifer; Francis, Jobbin; Punjabivaryani, Puja; Reyes, J Anonuevo; Pauls, Mathide; Reyes, M Anonuevo; Buck, Amanda; Hedstrom, Amanda; Hutchinson, Camille; Kirkland, Charlotte; Wilkes, Gwen; Newham, Jodie; Fleming, Lucy; Martins, Sheila; Fleck, Natacha; Franca, Alvaro; Chwal, Bruna; Oldoni, Carolina; Mantovani, Gabriel; Noll, Giovani; Zanella, Laisa; Soma, Marcelo; Secchi, Thais; Borelli, Wyllians; Marques Pontes Neto, Octavio; Rimoli, Brunna; da Cunha Silva, Gustavo Henrique; Machado Galvao Mondin, Leila Aparecida; Barbosa Cerantola, Rodrigo; Imthon, Alexandre; Esaki, Amanda; de Albuquerque, Ana Leticia Amorim; Pazini, Andreia; Massote Fontanini, Carlos; Matinez Rubio, Carlos; Milani, Cristiano; dos Santos, Daniel Teixeira; Dias, Francisco; Alves, Frederico; Riccioppa Rodrigues, Guilherme Gustavo; Santos Ferreira, Kamila; Pena Pereira, Marcia; Morillos, Matheus; Camilo, Millene; Vincenzi, Otavio; ds Cruz, Renato; Pegorer Santos, Bruno; Winckler, Fernanda; De Souza, Juli Thomaz; Bonome, Luana Aparecido Muondo; Ferreira, Natalia; Barbosa dos Santos, Daniel Fabiano; Modolo, Gabriel; dos Santos Moreira, Julio Cesar; Teodoro, Robson; Cury Silva, Vinicius; Cruz Guedes de Morais, Alessandra Braga; Vieira, Jose; Mendes, George; de Queiroz, Joao Paulo |
| Source: |
JAMA Neurology , 82 (12) pp. 1243-1250. (2025) |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2025 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Humans; Female; Male; Tenecteplase; Fibrinolytic Agents; Aged; Middle Aged; Ischemic Stroke; Treatment Outcome; Thrombolytic Therapy; Stroke |
| Description: |
Importance: Outcomes following intravenous thrombolysis for minor ischemic stroke may vary based on the presence of disabling deficits. Objective: To determine whether intravenous tenecteplase improves outcomes according to US National Institutes of Health Stroke Scale (NIHSS) score–based definitions of pretreatment disabling deficits. Design, Setting, and Participants: This is a secondary analysis of the TEMPO-2 (Tenecteplase vs Standard of Care for Minor Ischemic Stroke With Proven Occlusion) randomized clinical trial, conducted between April 27, 2015, and January 19, 2024. Patients were followed up for 90 days. The TEMPO-2 trial was conducted across 48 sites globally among patients with minor ischemic stroke (NIHSS 0-5) and proven intracranial occlusion within 12 hours of onset. Patients were divided into having nondisabling vs disabling syndromes at presentation as per the TREAT Task Force consensus. Other established definitions of disabling stroke from the ARAMIS trial and the National Institute of Neurological Disorders and Stroke trial were explored. Data analysis was completed from July 2024 to September 2024. Interventions: Intravenous tenecteplase (0.25 mg/kg) vs nonthrombolytic standard of care. Main Outcomes and Measures: The primary outcome was a return to baseline modified Rankin scale score at 90 days. Results: Among 886 enrolled patients, 2 withdrew consent and 884 were included in the secondary analysis. Among 884 patients analyzed (369 women [41.7%]; median [IQR] age, 72 [61-80] years), 100 (11.3%) had disabling and 784 (88.7%) had nondisabling deficits. Patients with disabling deficits had higher median (IQR) baseline NIHSS scores (4 [3-5] vs 2 [1-3]), later presentations (onset to hospital arrival time: 288 [153-412] minutes vs 133 [70-310] minutes), and longer onset to treatment time (411 [307-560] minutes vs 278 [170-462] minutes) than those with nondisabling deficits. In the disabling group, the primary outcome following tenecteplase, compared with standard of care, occurred in 29 ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10219364/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10219364/1/Farag_TEMPO2%20-%20Disabling%20Stroke_JAMANeurol_V3.2_0717_CLN%20%28002%29.pdf; https://discovery.ucl.ac.uk/id/eprint/10219364/ |
| Rights: |
open |
| Accession Number: |
edsbas.CAD5C |
| Database: |
BASE |