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

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

A study to assess clinical profile of Indian type 2 diabetes mellitus patients treated with Teneligliptin-ASPIRE study

Background: Teneligliptin is a DPP-4 inhibitor with unique chemical structure. Efficacy and safety of Teneligliptin is well established in the patients with type 2 diabetes mellitus (T2DM) in different randomized controlled trials. However, limited real-world data is available for Teneligliptin pertaining to Indian T2DM patient profile such as demographics, duration of disease, currently prescribed anti-hyperglycemic drugs, initiation of Teneligliptin as monotherapy or as an add on therapy.Methods: A cross-sectional, multicenter, non-interventional study was conducted to understand the demographics and clinical profile of Indian T2DM patients (n=5091) who were prescribed Teneligliptin.Results: Majority of patients were male (65.2%) with family history of T2DM present in 43.45% of cases. Age at onset of T2DM was 51.1±11.6 years. Among the T2DM patients, 36.2% of patients were newly diagnosed and more than half of them (54.7%) were uncontrolled with current anti-hyperglycemic drugs. Mean HbA1c level among these patients was 8.09±1.3%. Mean fasting and postprandial blood glucose levels were 170.2±46.9 mg/dl and 255.3±69.3 mg/dl respectively. Teneligliptin was prescribed as monotherapy in 2165 (41.66 %) of patients while as dual, triple and quadruple therapy in 2346 (46.08%) and 551 (10.82%) and 29 (0.56%) respectively. Among the patients on current anti-hyperglycemic treatment, most commonly prescribed drugs along with Teneligliptin were metformin (43.39%) followed by glimepiride (11%) and voglibose (3.42%).Conclusions: Teneligliptin is preferred as monotherapy and combination with metformin and sulfonylureas (mostly glimepiride) in newly diagnosed and uncontrolled T2DM patients in Indian scenario