2026-04-17T16:20:46Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/138182025-10-24T10:21:26Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Yu, Amy Ying Xin author Vatanpour, Shabnam author Ganesh, Aravind author Choi, Philip author Molina, Carlos author Field, Thalia author Barber, Philip author 2025-10-09T10:34:10Z 2025-10-09T10:34:10Z 2025-05-06 Sex; Stroke; Thrombolysis Sexe; Ictus; Trombòlisi Sexo; Ictus; Trombólisis Background In this subanalysis of the TEMPO‐2 (Tenecteplase Versus Standard of Care for Minor Ischaemic Stroke With Proven Occlusion) trial, a randomized clinical trial comparing tenecteplase and nonthrombolytic control in patients with minor stroke and symptomatic intracranial occlusion, we investigated sex differences in the efficacy and safety of tenecteplase. Methods We compared outcomes after tenecteplase versus control, stratified by sex. We also compared outcomes in female versus male patients treated with tenecteplase. The primary outcome was a “responder” outcome, defined as return to baseline modified Rankin Scale score at 90 days. Secondary outcomes included the Lawton Instrumental Activities of Daily Living Scale, the EuroQol‐5 Dimension, vessel recanalization, and adverse events. We used generalized linear modeling with a Poisson distribution adjusted for baseline differences to calculate adjusted risk ratios (aRR) and 95% CIs. Results There were 884 patients in the intention‐to‐treat analysis (48.9% tenecteplase, 41.5% female). Among female participants, the tenecteplase group was less likely to be a responder compared with control (63.8% tenecteplase, 73.9% control, aRR, 0.87 [95% CI, 0.76–1.00]). Among male participants, the responder outcome was similar between groups (77.5% tenecteplase, 75.4% control, 1.03 [95% CI, 0.94–1.13]). Female participants randomized to tenecteplase were less likely to be responders than male counterparts (63.8% female, 77.5% male, 0.85 [95% CI, 0.75–0.96]). Early recanalization was more frequent after tenecteplase than control in both sexes. Conclusions Tenecteplase was not associated with better clinical outcomes over nonthrombolytic control in female or male patients with minor ischemic stroke, despite more frequent recanalization. Fewer women treated with tenecteplase returned to baseline function compared with men. Funding for the TEMPO‐2 trial is from grants from Heart and Stroke Foundation of Canada, Canadian Institutes of Health Research, and the British Heart Foundation (CS/18/5/34081). Intravenous tenecteplase is a standard off‐the‐shelf drug and was paid for by Boehringer Ingelheim, who had no role in the trial design or conduct, data analysis, or article preparation. http://hdl.handle.net/11351/13818 Avaluació de resultats (Assistència sanitària) Fibrinolítics - Ús terapèutic Malalties cerebrovasculars - Tractament Malalties cerebrovasculars - Factors sexuals ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Fibrin Modulating Agents::Fibrinolytic Agents Other subheadings::Other subheadings::/therapeutic use DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke Other subheadings::Other subheadings::Other subheadings::/drug therapy HEALTH CARE::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Sex Factors TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::moduladores de la fibrina::fibrinolíticos Otros calificadores::Otros calificadores::/uso terapéutico ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia ATENCIÓN DE SALUD::calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::factores epidemiológicos::factores sexuales Sex Differences in Outcomes After Tenecteplase for Minor Stroke: A Subanalysis of the TEMPO‐2 Trial