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1
This systematic review evaluates the efficacy and safety of intravenous thrombolytic agents for acute ischemic stroke within 4.5 to 24 hours of symptom onset.
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2
Ten randomized controlled trials involving 2,409 patients were included, comparing alteplase, tenecteplase, JX10, standard of care, and placebo.
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3
Alteplase significantly improved functional independence at 90 days compared to standard care, while JX10 and tenecteplase showed trends without statistical significance.
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4
Alteplase was associated with a higher risk of symptomatic intracranial hemorrhage compared to standard care, while JX10 had the highest bleeding risk.
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5
The evidence quality was predominantly low to very low, highlighting the need for larger, rigorously designed trials to better assess thrombolytic therapy efficacy.
