Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit-TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit.

2022-04-29

Bivard, Andrew

Zhao, Henry

Coote, Skye

Campbell, Bruce

Churilov, Leonid

Yassi, Nawaf

Yan, Bernard

Valente, Michael

Sharobeam, Angelos

Balabanski, Anna

Dos Santos, Angela

Ng, Felix C

Langenberg, Francesca

Stephenson, Michael

Smith, Karen

Bernard, Steve

Thijs, Vincent N

Cloud, Geoffrey

Choi, Philip

Ma, Henry

Wijeratne, Tissa

Chen, Chushuang

Olenko, Liudmyla

Davis, Stephen M

Donnan, Geoffrey A

Parsons, Mark

Computed tomography

Neurology

STROKE MEDICINE

Stroke

Journal Article

0000-0002-4320-4287

0000-0001-6014-846X

0000-0002-6614-8417

10.1136/bmjopen-2021-056573

Mobile stroke units (MSUs) equipped with a CT scanner are increasingly being used to assess and treat stroke patients' prehospital with thrombolysis and transfer them to the most appropriate hospital for ongoing stroke care and thrombectomy when indicated. The effect of MSUs in both reducing the time to reperfusion treatment and improving patient outcomes is now established. There is now an opportunity to improve the efficacy of treatment provided by the MSU. Tenecteplase is a potent plasminogen activator, which may have benefits over the standard of care stroke lytic alteplase. Specifically, in the MSU environment tenecteplase presents practical benefits since it is given as a single bolus and does not require an infusion over an hour like alteplase. In this trial, we seek to investigate if tenecteplase, given to patients with acute ischaemic stroke as diagnosed on the MSU, improves the rate of early reperfusion. TASTE-A is a prospective, randomised, open-label, blinded endpoint (PROBE) phase II trial of patients who had an ischaemic stroke assessed in an MSU within 4.5 hours of symptom onset. The primary endpoint is early reperfusion measured by the post-lysis volume of the CT perfusion lesion performed immediately after hospital arrival. The study was approved by the Royal Melbourne Hospital Human Ethics committee. The findings will be published in peer-reviewed journals, presented at academic conferences and disseminated among consumer and healthcare professional audiences. NCT04071613.

link

BMJ open 2022; 12(4): e056573

BMJ open