International Journal of Research in Medical Sciences | March 2021 | Vol 9 | Issue 3 Page 724 International Journal of Research in Medical Sciences Jadhav AY et al. Int J Res Med Sci. 2021 Mar;9(3):724-728 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Role of Tenecteplase in management of acute ischemic stroke: a knowledge, attitude, and practice survey among Indian neurologists Amit Y. Jadhav*, Rajnish M. Dhediya, Onkar C. Swami INTRODUCTION Stroke is defined as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS) (i.e. brain, retina, or spinal cord) by a vascular cause. 1 There are two types of stroke one of most common which is ischaemic stroke due to abridged blood flow, generally resulting from arterial occlusion. The remaining 10-40% of stroke are haemorrhagic and result from the rupture of cerebral arteries. Globally there are 9.6 million acute ischemic stroke (AIS) cases while 4·1 million haemorrhagic strokes (including intracerebral and subarachnoid haemorrhage) each year. 2 Acute treatments for ischaemic stroke comprises Intravenous (IV) thrombolysis with recombinant human tissue plasminogen activator or mechanical thrombectomy aims to re-perfuse the ischaemic brain. Currently in India, Alteplase and Tenecteplase are the approved drugs for intravenous (IV) thrombolysis. They act by converting Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra, India Received: 29 December 2020 Revised: 28 January 2021 Accepted: 29 January 2021 *Correspondence: Dr. Amit Y Jadhav, E-mail: amity.jadhav@emcure.co.in Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT 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. Keywords: Tenecteplase, Ischemic stroke, KAP survey, Questionnaire, Thrombolytic DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20210485