Tenecteplase in Acute Stroke: What About the Children?

Lisa R. Sun; Jenny L. Wilson; Michaela Waak; Amy Kiskaddon; Neil A. Goldenberg; Lori C. Jordan; Megan Barry

doi:10.1161/STROKEAHA.123.042951

Tenecteplase in Acute Stroke: What About the Children?

Lisa R. Sun^*, Jenny L. Wilson, Michaela Waak, Amy Kiskaddon, Neil A. Goldenberg, Lori C. Jordan, Megan Barry

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Review article › peer-review

4 Scopus citations

Abstract

Tenecteplase is replacing alteplase as the fibrinolytic agent of choice for the acute management of ischemic stroke in many adult stroke centers due to practical and pharmacokinetic advantages in the setting of similar outcomes. Although thrombolytic use is increasing for acute childhood stroke, there is very limited experience with tenecteplase in children for any indication, and importantly, there are no data on safety, dosing, or efficacy of tenecteplase for childhood stroke. Changes in fibrinolytic capacity over childhood, pediatric pharmacological considerations such as age-specific differences in drug clearance and volume of distribution, and practical aspects of drug delivery such as availability in children's hospitals may impact decisions about transitioning from alteplase to tenecteplase for acute pediatric stroke treatment. Pediatric and adult neurologists should prepare institution-specific guidelines and organize prospective data collection.

Original language	English (US)
Pages (from-to)	1950-1953
Number of pages	4
Journal	Stroke
Volume	54
Issue number	7
DOIs	https://doi.org/10.1161/STROKEAHA.123.042951
State	Published - Jul 1 2023

Funding

Dr Sun receives research and salary support from the American Heart Association (Career Development Award 850044). Dr Goldenberg receives research and salary support from the National Institutes of Health, National Heart Lung and Blood Institute for investigation into venous thromboembolism in patients <21 years old. He receives or recently received consultancy fees from Anthos Therapeutics, Bayer, Boehringer-Ingelheim, Chiesi, Daiichi Sankyo, and the University of Colorado-affiliated Academic Research Organization CPC Clinical Research for roles in clinical trial planning or oversight committees in pharmaceutical industry-sponsored pediatric clinical trials of antithrombotics. The other authors report no conflicts.

Keywords

alteplase
child
fibrinolytic agent
ischemic stroke
tenecteplase

ASJC Scopus subject areas

Clinical Neurology
Cardiology and Cardiovascular Medicine
Advanced and Specialized Nursing

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10.1161/STROKEAHA.123.042951

Cite this

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title = "Tenecteplase in Acute Stroke: What About the Children?",

abstract = "Tenecteplase is replacing alteplase as the fibrinolytic agent of choice for the acute management of ischemic stroke in many adult stroke centers due to practical and pharmacokinetic advantages in the setting of similar outcomes. Although thrombolytic use is increasing for acute childhood stroke, there is very limited experience with tenecteplase in children for any indication, and importantly, there are no data on safety, dosing, or efficacy of tenecteplase for childhood stroke. Changes in fibrinolytic capacity over childhood, pediatric pharmacological considerations such as age-specific differences in drug clearance and volume of distribution, and practical aspects of drug delivery such as availability in children's hospitals may impact decisions about transitioning from alteplase to tenecteplase for acute pediatric stroke treatment. Pediatric and adult neurologists should prepare institution-specific guidelines and organize prospective data collection.",

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author = "Sun, {Lisa R.} and Wilson, {Jenny L.} and Michaela Waak and Amy Kiskaddon and Goldenberg, {Neil A.} and Jordan, {Lori C.} and Megan Barry",

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T2 - What About the Children?

AU - Sun, Lisa R.

AU - Wilson, Jenny L.

AU - Waak, Michaela

AU - Kiskaddon, Amy

AU - Goldenberg, Neil A.

AU - Jordan, Lori C.

AU - Barry, Megan

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Tenecteplase is replacing alteplase as the fibrinolytic agent of choice for the acute management of ischemic stroke in many adult stroke centers due to practical and pharmacokinetic advantages in the setting of similar outcomes. Although thrombolytic use is increasing for acute childhood stroke, there is very limited experience with tenecteplase in children for any indication, and importantly, there are no data on safety, dosing, or efficacy of tenecteplase for childhood stroke. Changes in fibrinolytic capacity over childhood, pediatric pharmacological considerations such as age-specific differences in drug clearance and volume of distribution, and practical aspects of drug delivery such as availability in children's hospitals may impact decisions about transitioning from alteplase to tenecteplase for acute pediatric stroke treatment. Pediatric and adult neurologists should prepare institution-specific guidelines and organize prospective data collection.

AB - Tenecteplase is replacing alteplase as the fibrinolytic agent of choice for the acute management of ischemic stroke in many adult stroke centers due to practical and pharmacokinetic advantages in the setting of similar outcomes. Although thrombolytic use is increasing for acute childhood stroke, there is very limited experience with tenecteplase in children for any indication, and importantly, there are no data on safety, dosing, or efficacy of tenecteplase for childhood stroke. Changes in fibrinolytic capacity over childhood, pediatric pharmacological considerations such as age-specific differences in drug clearance and volume of distribution, and practical aspects of drug delivery such as availability in children's hospitals may impact decisions about transitioning from alteplase to tenecteplase for acute pediatric stroke treatment. Pediatric and adult neurologists should prepare institution-specific guidelines and organize prospective data collection.

KW - alteplase

KW - child

KW - fibrinolytic agent

KW - ischemic stroke

KW - tenecteplase

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SN - 0039-2499

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JO - Stroke

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ER -

Tenecteplase in Acute Stroke: What About the Children?

Abstract

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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