Role of Tenecteplase in management of acute ischemic stroke: a knowledge, attitude, and practice survey among Indian neurologists


  • Amit Y. Jadhav Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra
  • Rajnish M. Dhediya Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra
  • Onkar C. Swami Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra



Tenecteplase, Ischemic stroke, KAP survey, Questionnaire, Thrombolytic


Background: Tenecteplase, a third generation tissue plasminogen activator has important place in the thrombolytic therapy in acute ischemic stroke. The objective of present study was to understand the knowledge, attitude and practice (KAP) towards the usage of tenecteplase in daily clinical practice.

Methods: This was a prospective questionnaire based knowledge, attitude and practice survey with involvement of practising neurologists across the country. A specially designed validated questionnaire containing 18 questions was shared with neurologists and their anonymous inputs were captured and analysed in qualitative manner.

Results: Total Sixty-eight neurologists completed this questionnaire. The 73 percent of neurologist preferred tenecteplase in stroke patients arriving within 4.5 hours of onset of stroke symptoms. Almost 70% of neurologists preferred tenecteplase in patients <60 years of age with average NIHSS score between 5-15. The preferred dosage was 0.2 mg/kg by majority (78%). Bridging therapy was used up to 0-10% of patients by 70% neurologists which ultimately has lesser bleeding chances. 46% neurologists reported that no sICH after tenecteplase, while 30% reported in <1% patients. Almost 70% neurologists reported no allergic reaction noted with tenecteplase. Overall, 70% neurologists reported good to very good improvement in the patient’s quality of life at 90 days after tenecteplase therapy.

Conclusions: The current KAP survey emphasized tenecteplase as a commonly preferred thrombolytic agent in acute ischemic stroke with better efficacy and safety, affordable cost with single bolus administration.

Author Biographies

Amit Y. Jadhav, Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra

Dy. Manager, Medical Services

Rajnish M. Dhediya, Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra

Manager, Medical Services

Onkar C. Swami, Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra

Director, Medical Services


Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(7):2064-89.

Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurol. 2019;18(5):439-58.

Campbell BC, Khatri P. Stroke. The Lancet. 2020;396(10244):129-42.

Keyt BA, Paoni NF, Refino CJ, Berleau L, Nguyen H, Chow A, et al. A faster-acting and more potent form of tissue plasminogen activator. Proceedings of the National Acad Sci. 1994;91(9):3670-4.

Campbell BC, Mitchell PJ, Churilov L, Yassi N, Kleinig TJ, Dowling RJ, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. New Eng J Med. 2018;378(17):1573-82.

Ramakrishnan TC, Kumaravelu S, Narayan SK, Buddha SS, Murali C, Majeed PH, et al. Efficacy and safety of intravenous tenecteplase bolus in acute ischemic stroke: results of two open-label, multicenter trials. Am J Cardiovascular Drugs. 2018;18(5):387-95.

Malik S, Swami OC, Prasad S, Talwar P, Verma S, Jain K, et al. Clomiphene citrate usage pattern in India: A knowledge, attitude, and practice survey among gynecologists. Fertility Sci Res. 2014;1(2):92.

Guidelines for Prevention and Management of Stroke published by NPCDCS, Ministry of Health and Family Welfare, Govt. of India, 2019. Available at: programmes/non-communicable-diseases-injury-trauma/Non-Communicable-Disease-II/National-Programme-for-Prevention-and-Control-of-Cancer-Diabetes-Cardiovascular-diseases-and-Stroke-NPCDCS. Accessed on 16 December 2020.

Gao L, Moodie M, Mitchell PJ, Churilov L, Kleinig TJ, Yassi N, Yan B, Parsons MW, Donnan GA, Davis SM, Campbell BC. Cost-Effectiveness of Tenecteplase Before Thrombectomy for Ischemic Stroke. Stroke. 2020;51(12):3681-9.

Wouters A, Nysten C, Thijs V, Lemmens R. Prediction of outcome in patients with acute ischemic stroke based on initial severity and improvement in the first 24 h. Frontiers Neurol. 2018;9:308.

Tudor R, Iovanescu G, Reisz D, Cornea A, Potre-Oncu C, Tutelca A, Simu M. Additional factors to corelate with a more than 30% NIHSS score improvement in patients 7 days after fibrinolytic and/or endovascular treatment for ischemic stroke. BMC Neurol. 2020;20(1):1-7.

Warach SJ, Dula AN, Milling Jr TJ. Tenecteplase Thrombolysis for Acute Ischemic Stroke. Stroke. 2020;51(11):3440-51.




How to Cite

Jadhav, A. Y., Dhediya, R. M., & Swami, O. C. (2021). Role of Tenecteplase in management of acute ischemic stroke: a knowledge, attitude, and practice survey among Indian neurologists. International Journal of Research in Medical Sciences, 9(3), 724–728.



Original Research Articles