A Multicentre, Prospective, Randomized, Open Label, Blinded-endpoint Trial to Optimize the Use of Intravenous Tenecteplase in Participants With Acute Ischemic Stroke (ACT-GLOBAL THROMBOLYSIS (ACT WHEN-001) Within A Multi-faCtorial, mulTi-arm, Multi-staGe, Randomised, gLOBal Adaptive pLatform Trial for Stroke (ACT-GLOBAL) NCT06352632

This domain has a prospective, randomized, controlled, open-label, parallel group with blinded endpoint assessment (PROBE) design. Up to 4,000 patients with presumed acute ischemic stroke (AIS) will be followed for 90 days (or until death, if prior to 90 days). The end of the trial is defined as the date that all participants have completed their Day 90 assessment.
This domain aim is to efficiently, reliably, and simultaneously, determine the comparative effectiveness of intravenous thrombolysis (IVT) using standard-dose intravenous tenecteplase (0.25 mg/kg body weight), vs. low-dose intravenous tenecteplase (0.18 mg/kg body weight) in all patients who present to hospital with acute ischemic stroke and are considered for intravenous thrombolysis. In addition, this domain also seeks to study standard-dose intravenous tenecteplase (0.25 mg/kg body weight), vs. low-dose intravenous tenecteplase (0.18 mg/kg body weight) vs. no TNK upfront with rescue IA TNK if necessary (in those eligible for emergency EVT) and no TNK upfront in those who have taken DOACs during the preceding 24 hours. This domain therefore seeks to generate more robust randomized evidence to guide clinicians in their decisions over the balance of risks and treatment with intravenous thrombolysis with tenecteplase wherever such evidence is currently insufficient.
This domain will currently evaluate four research questions in relation to the use of IVT with tenecteplase:
In patients with recent (24 hours) intake of a standard-dose direct oral anticoagulant (DOAC), how should IVT be used? - Use standard-dose (0.25 mg/kg body weight) or low-dose tenecteplase (0.18 mg/kg) or not at all.
In patients planned to be treated with endovascular thrombectomy, how should tenecteplase be used? -Treat with IV tenecteplase (standard- or low-dose) or not at all.
In any patient receiving IVT, what is the optimal dose of tenecteplase? - use standard-dose (0.25 mg/kg body weight) or low-dose tenecteplase (0.18 mg/kg).
To what extent is the treatment effect of standard- vs. low-dose tenecteplase modified by key patient characteristics, such as diabetes, prior antiplatelet therapy, renal failure, or frailty, old age or having a heavy burden of cerebral small vessel disease on brain imaging.

Start Date15 Jun 2024

Sponsor / Collaborator

University of Calgary

[+1]

NCT06414499 / RecruitingPhase 3IIT

TNK-tPA Treatment for Acute Minor Ischemic Stroke：A Multicenter, Prospective, Open Label, Blinded-endpoint, Randomized Controlled Trial

The trial is a multicenter, prospective, open-label, blinded-endpoint randomized controlled design. Participants with acute minor ischemic stroke (baseline NIHSS≤5) accompanied with measurable neurological deficit will be randomized 1:1 to 0.25mg/kg intravenous tenecteplase or standard medical treatment.

Start Date20 May 2024

Sponsor / Collaborator

Beijing Tiantan Hospital

NCT06352632 / Not yet recruitingPhase 3IIT

A Multi-faCtorial, mulTi-arm, Multi-staGe, Randomised, gLOBal Adaptive pLatform Trial for Stroke (ACT-GLOBAL)

Stroke is causing 6.6 million deaths and is a major cause of disability worldwide in 2019. There remains an urgent need for interventions that improve outcomes which can be implemented with wide applicability for stroke. ACT-GLOBAL is a multi-factorial, multi-arm, multi-stage, randomised, global adaptive platform trial for stroke, aiming to identify the treatment/s associated with the highest chance of improving outcome in stroke patients. In ACT-GLOBAL multiple questions will be evaluated simultaneously and sequentially as data accrues and can evaluate interactions between different treatment options.

Start Date01 May 2024

Sponsor / Collaborator

The George Institute for Global Health

[+2]

100 Clinical Results associated with Tenecteplase

100 Translational Medicine associated with Tenecteplase

100 Patents (Medical) associated with Tenecteplase

782

Literatures (Medical) associated with Tenecteplase

27 Feb 2024·Stroke and vascular neurology

Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial.

Article

Author: Li, Hao ; Xiong, Yunyun ; Fisher, Marc ; Meng, Xia ; Schwamm, Lee H ; Campbell, Bruce C V ; Parsons, Mark ; Zhao, Xingquan ; Wang, Yongjun ; Pan, Yuesong

BACKGROUND AND PURPOSE:

Recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) was not inferior to alteplase for ischaemic stroke within 4.5 hours. Our study aimed to investigate the efficacy and safety of rhTNK-tPA in patients who had an ischaemic stroke due to large vessel occlusion (LVO) of anterior circulation beyond 4.5 hours.

METHODS AND DESIGN:

Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events-III (TRACE III) is a multicentre, prospective, randomised, open-label, blind endpoint, controlled clinical trial. Patients who had an ischaemic stroke due to anterior circulation LVO (internal carotid artery, middle cerebral artery M1 and M2 segments) within 4.5-24 hours from last known well (including wake-up stroke and no witness stroke) and with salvageable tissue (ischaemic core volume <70 mL, mismatch ratio ≥1.8 and mismatch volume ≥15 mL) based on CT perfusion or MRI perfusion-weighted imaging (PWI) were included and randomised to rhTNK-tPA 0.25 mg/kg (single bolus) to a maximum of 25 mg or standard medical therapy. Specially, we will exclude patients who are intended for direct thrombectomy. All will be followed up for 90 days.

STUDY OUTCOMES:

Primary efficacy outcome is modified Rankin Scale (mRS) score ≤1 at 90 days. Secondary efficacy outcomes include ordinal distribution of mRS at 90 days, major neurological improvement defined by a decrease ≥8 points compared with the initial deficit or a score ≤1 on the National Institutes of Health Stroke Scale (NIHSS) at 72 hours, mRS score ≤2 at 90 days, the rate of improvement on Tmax >6 s at 24 hours and NIHSS score change from baseline at 7 days. Safety outcomes are symptomatic intracerebral haemorrhage within 36 hours and mortality at 90 days.

DISCUSSION:

TRACE III will provide evidence for the efficacy and safety of rhTNK-tPA in patients who had an ischaemic strokes due to anterior circulation LVO beyond 4.5 hours.

TRIAL REGISTRATION NUMBER:

NCT05141305.

27 Feb 2024·Stroke and vascular neurology

Intra-arterial tenecteplase during thrombectomy for acute stroke (BRETIS-TNK II): rationale and design.

Article

Author: Qiu, Jing ; Li, Wei ; Li, Di ; Zhao, Zi-Ai ; Chen, Hui-Sheng ; Wang, Shouchun ; Shi, Huaizhang ; Nguyen, Thanh ; Wang, Feng ; Wei, Ming

BACKGROUND:

Our recent pilot study suggests intra-arterial tenecteplase (TNK) during the first pass of endovascular treatment (EVT) seems safe, may increase first-pass reperfusion and good outcome in acute ischaemic stroke (AIS) patients with large-vessel occlusion (LVO).

AIMS:

To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom onset.

SAMPLE SIZE ESTIMATES:

A maximum of 380 patients are required to test the superiority hypothesis with 80% power according to a two-side 0.05 level of significance, stratified by age, gender, baseline systolic blood pressure, prestroke modified Rankin Scale (mRS), baseline National Institute of Health stroke scale, baseline ASPECTS, time from onset to groin puncture, intravenous thrombolysis before EVT, stroke territory and stroke aetiology.

DESIGN:

Intra-arterial TNK during thrombectomy for acute stroke (BRETIS-TNK II) study is a prospective, randomised, adaptive enrichment, open-label, blinded end point, multicentre study. Eligible AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:1. The experimental group will be treated with intra-arterial infusion of TNK during EVT. The control group will be treated with standard EVT.

OUTCOME:

The primary end point is a favourable outcome, defined as an mRS score of 0-2 at 90 days. The primary safety end point is symptomatic intracranial haemorrhage within 48 hours, which is defined as an increase in the National Institutes of Health Stroke Scale score of ≥4 points as a result of the intracranial haemorrhage.

CONCLUSIONS:

The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.

05 Feb 2024·Chinese medical journal

Tenecteplase versus alteplase in treatment of acute ST-segment elevation myocardial infarction: A randomized non-inferiority trial

Article

Author: Gao, Runlin ; Ding, Yutian ; Li, Wanke ; Gao, Wen ; Wang, Limei ; Rong, Juwen ; Wu, Yangfeng ; Dang, Wanjun ; Zhao, Xingshan ; Ma, Liping ; Yang, Qin ; Wang, Haibo ; Xia, Qingde ; Guo, Qiang ; Cheng, Guanchang ; Zhang, Zheng ; Xu, Haiyan ; Qiao, Shubin ; Yang, Yuwang ; Qi, Liping ; Zhu, Yidan ; Yao, Chen ; Tao, Guizhou ; Yan, Xiaoyan

Abstract:

Background::

A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.

Methods::

In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.

Results::

From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA (n = 384) or rt-PA (n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups.

Conclusion::

rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.

Trial registration::

www.ClinicalTrials.gov (No. NCT02835534).

News (Medical) associated with Tenecteplase

20 May 2024

·www.prnewswire.com

31-year-old Mercy EMS Co-worker Recovers From Stroke That Occurred While On-duty

ADA, Okla., May 20, 2024 /PRNewswire/ -- Dillion Kirkland is a 31-year-old Mercy emergency medical technician who works with life-threatening injuries and illnesses every day. Last October, he found himself on the receiving end of care when he was taken to the emergency department by his own co-workers after he experienced a stroke. May is American Stroke Month and this week is National EMS Week, making Kirkland's story important and reinforcing stroke awareness and treatment through in-person and virtual care. For his complete story and video, click here. Continue Reading "I'm 31, I can't be having a stroke. Even with all my training and experience, I couldn't process what was happening." Post this Kirkland was in the driver's seat of an ambulance after a routine patient transfer when he started feeling strange. He asked his partner, Brian Ridgway, to take the wheel. But after arriving back in Ada, Oklahoma, his symptoms continued to worsen. Kirkland's paramedic partner recognized something was seriously wrong and loaded him up in his own ambulance and took him straight to the ER. "Brian told me, 'I think you're having a stroke,' but I thought, 'I'm 31, I can't be having a stroke,'" said Kirkland. "Even with all my training and experience, I couldn't process what was happening. It progressed to where I couldn't speak, I couldn't formulate a sentence, everything was garbled and delayed. What I wanted to say in my brain just wouldn't come out of my mouth." According to the Centers for Disease Control and Prevention, someone experiences a stroke every 40 seconds in the United States, and stroke remains one of the leading causes of death and long-term disability. While stroke risk increases with age, a stroke can occur at any age. After Kirkland arrived in the Mercy Hospital Ada emergency department, he was evaluated and connected with a Mercy Virtual neurologist. Sensing the urgency of the situation, the virtual neurologist rushed the local team to administer a beta-blocker to lower blood pressure and a clot-dissolving stroke medication called Tenecteplase (TNK). "Our team quickly evaluated Dillion and gave him the medication he needed," said Dr. Advait Mahulikar, a member of Kirkland's virtual neurology team. "The quick actions and assessment of our team combined with clot-busting medication helped prevent the worsening of symptoms that could have potentially become disabling, especially at such a young age." Mercy Virtual has a team of neurologists who provide care 24/7 to 31 Mercy facilities across four states. Depending on a hospital's needs, Mercy Virtual supplements in-person neurology care or provides full neurology coverage for many rural hospitals unable to staff full-time physicians. This allows the local team to work collaboratively at a patient's bedside without spending extra time transporting them to larger trauma centers. "Virtual care has literally changed the lives of thousands of patients by providing access to a neurologist when it matters most during a time-sensitive diagnosis like stroke," said Dr. Meghan Rodden, physician lead of Mercy Virtual stroke care. "Time is brain, and a typical patient can lose 1.9 million neurons each minute a stroke is untreated. That is why it's essential that our virtual neurologists do a combination of bedside and virtual work so some of our smaller facilities can get access to the specialized care they need faster." With the help of his in-person and virtual care team, Kirkland's story has a happy ending. "After the TNK medication was administered, my symptoms were resolved within 30 minutes, and I've fully recovered with no deficits to this day," he said. "TNK was actually a relatively new standard of stroke care. It was something we had recently discussed as an EMS team, but I had yet to see it in action, so it was scary to try it myself firsthand. I'm a firm believer in TNK now." While Kirkland didn't have the typical stroke symptoms of one-sided weakness, he had overall coordination loss, garbled speech and an extremely elevated blood pressure. Mercy recommends the acronym B.E.F.A.S.T. if someone is believed to be having a stroke. B – Balance: Does the person complain of sudden dizziness or difficulty walking? E – Eyes: Does the person complain of blurred vision, seeing dark or bright spots? F – Face: Ask the person to smile. Is the smile even or lop-sided? A – Arms: Ask the person to raise both arms. Does one arm drift downward? S – Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange? T – Time: If you see any of these signs, call 9-1-1 right away and note the time. Observers should record the time when any symptoms first appear to help health professionals plan the best treatment and minimize long-term stroke damage. Kirkland is back at work saving lives, but he hopes sharing his story will help spread awareness. "Knowing the signs is important for everyone and can make a big difference in recovery or even between life and death," Kirkland said. "When in doubt, call 9-1-1 and seek medical attention." About Mercy Mercy, one of the 20 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized care and one of the nation's largest and highest performing Accountable Care Organizations in quality and cost. Mercy is a highly integrated, multi-state health care system including more than 50 acute care and specialty (heart, children's, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has over 900 physician practice locations and outpatient facilities, more than 4,500 physicians and advanced practitioners and 50,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In fiscal year 2023 alone, Mercy provided more than half a billion dollars of free care and other community benefits, including traditional charity care and unreimbursed Medicaid. SOURCE Mercy

16 May 2024

·www.prnewswire.com

Brainomix Announces New Studies Further Validating the Impact of Brainomix 360 Stroke Platform

With these latest studies, the firmly established European market leader in stroke AI imaging adds to its growing body of evidence. The latest research reflects the company's extensive academic collaborations and its growing Life Science partnerships. OXFORD, England and CHICAGO, May 16, 2024 /PRNewswire/ -- Brainomix, a pioneer in artificial intelligence (AI) imaging solutions to enable precision medicine, announced a series of new studies that were presented this week at the European Stroke Organisation Conference (ESOC) in Basel. The studies validated the impact of the Oxford-based company's Brainomix 360 Stroke platform, including its FDA-cleared Triage Stroke tool and its flagship e-ASPECTS software. The studies follow Wednesday's presentation at ESOC of a groundbreaking study, the largest prospective evaluation of stroke AI imaging, involving more than 80,000 patients at 26 sites over a 3-year period. This study showed that the implementation of Brainomix 360 Stroke was associated with an additional 50% increase in the number of patients receiving mechanical thrombectomy and a reduction in door-in-door-out (DIDO) time of around 50 minutes. Dr Michalis Papadakis, CEO and Co-Founder of Brainomix, said: "The studies presented this week at ESOC reflect our ongoing commitment to scientific excellence and our extensive academic collaborations with world-class research institutions, including the Mayo Clinic, the Rockefeller Institute at West Virginia University, and Boston Medical Center. These studies provide further validation that our AI-enabled technology can play a critical role in stroke care, helping clinicians make more confident decisions leading to more patients getting access to life-saving treatments. "We are also proud to showcase the growing body of research we are conducting with Life Science partners. Our unique set of imaging biomarkers and clinical trial tools, along with our world-class core lab team, are delivering real value for pharma partners, device manufacturers and biotech companies, generating insights that may guide future clinical trial design." Key abstracts accepted and presented at ESOC included: "Large Vessel Occlusion Detection in Acute Ischemic Stroke Using Non-Contrast CT" was a multisite collaboration with the Mayo Clinic, the Rockefeller Neuroscience Institute at West Virginia University, and Boston Medical Center validating Triage Stroke as a reliable tool for large vessel occlusion (LVO) detection. The authors concluded that when coupled with clinical information such as NIHSS, the tool may help centers to identify thrombectomy candidates, especially those with constrained resources and basic imaging. Brainomix and CSL Behring jointly published a retrospective observational study, "Automatically Quantified Follow-Up Imaging Biomarkers as Predictors of Clinical Outcomes after Acute Ischemic Stroke: A Real-World Evidence Study." After processing NCCT follow-up images with Brainomix 360 Stroke software, the results validated the prognostic significance of automated final infarct volume (FIV) and its components, confirming the opportunity for AI-derived imaging biomarkers at follow-up time points to improve the design and delivery of randomized controlled trials in AIS. Brainomix and Acticor jointly published a poster, "Patients Randomized to Glenzocimab Suffered Less Hemorrhagic Transformation with Greater Benefit in Larger Baseline Infarct Core," which helped to elucidate the mechanism and demonstrate the efficacy of Acticor's drug, glenzocimab, while identifying subgroups of patients who appear to benefit the most. A UK study, "WOW (With Or Without): Measuring Impact of e-ASPECTS Software on Conventional CT Reporting in Acute Ischemic Stroke," validated the impact of e-ASPECTS on reader performance. "e-ASPECTS is a valuable tool for clinicians in the speedy and accurate diagnosis of acute ischemic stroke (AIS), and has the potential to enable the identification of AIS patients in centres without neuroradiology expertise, improving access to life-saving treatment," noted Dr Anna Podlasek, lead author of the study. RESILIENT Extend IV, an ongoing randomized controlled trial assessing Tenecteplase in non-LVO AIS patients in the extended time window, will provide an update on its progress. The Brazilian trial is using Brainomix 360 e-CTP for patient selection. About Brainomix Brainomix specializes in the creation of AI-powered software solutions to enable precision medicine for better treatment decisions in stroke and lung fibrosis. With origins as a spin-out from the University of Oxford, Brainomix is an expanding commercial-stage company with offices in the UK, Ireland and the USA, and operations in more than 30 countries. A private company, backed by leading healthtech investors, Brainomix has innovated award-winning imaging biomarkers and software solutions that have been clinically adopted in hundreds of hospitals worldwide. Its first product, the Brainomix 360 stroke platform, provides clinicians with the most comprehensive stroke imaging solution, driving increased treatment rates and improving functional independence for patients. To learn more about Brainomix and its technology visit , and follow us on Twitter, LinkedIn and Facebook. Contacts Jeff Wyrtzen, Chief Marketing & Business Development Officer [email protected] M +44 (0)7927 164210 T +44 (0)1865 582730 Media enquiries Charles Consultants Sue Charles [email protected] M +44 (0)7968 726585 Logo - SOURCE Brainomix

Clinical ResultClinical Study

01 Feb 2024

·www.globenewswire.com

[Ad hoc announcement pursuant to Art. 53 LR] Roche exceeds guidance and achieves sales growth of 1% (CER) for 2023 despite sharp COVID-19 sales decline

Group sales grow by 1%1 at constant exchange rates (CER; -7% in CHF), more than offsetting the decline in COVID-19-related sales and biosimilar erosion, and thereby exceeding 2023 guidanceExcluding COVID-19 products, Group sales increase by 8% Pharmaceuticals Division sales increase by 6% (excluding COVID-19 medicine Ronapreve: +9%) due to ongoing high demand for newer medicines, with eye medicine Vabysmo continuing to be the top growth driver, followed by Ocrevus (multiple sclerosis), Hemlibra (haemophilia A) and Polivy (blood cancer) Diagnostics Division sales are 13% lower due to high demand for COVID-19 tests in 2022; strong momentum in the Diagnostics Division’s base business continues with an increase of 7% Highlights in the fourth quarter of 2023 and January 2024: US approval of Vabysmo (retinal vein occlusion, a severe eye disease) US priority review of Xolair (food allergies)EU approval of subcutaneous form of Tecentriq (cancer immunotherapy)Positive phase III data for inavolisib (breast cancer), Xolair (food allergies) and Hemlibra (babies with severe haemophilia A); positive longer-term data for Columvi and Lunsumio (blood cancer); positive long-term data for Kadcyla (breast cancer)US Breakthrough Device Designation for Elecsys NfL test (multiple sclerosis); launch of innovative new assays (hepatitis B and E)Acquisitions of Telavant (inflammatory bowel disease and other immunologic disorders) and Carmot (obesity and other metabolic diseases); acquisition agreement with LumiraDx (point-of-care technology platform)Roche (3rd) and Chugai (2nd) in Dow Jones Sustainability Indices IFRS net income increases 7% (-9% in CHF) to CHF 12.4 billion Core earnings per share increase by 6% (-9% in CHF) Board proposes dividend increase to CHF 9.60Change in Board of Directors Outlook for 2024Roche expects an increase in Group sales in the mid single digit range (at constant exchange rates). Core earnings per share are targeted to develop broadly in line with sales growth (at constant exchange rates), excluding the impact from resolution of tax disputes in 2023. Roche expects to further increase its dividend in Swiss francs. Key figures CHF millions % change January–December 2023 2023 2022 At CER1 In CHF Group sales 58,716 63,281 1 -7 Pharmaceuticals Division 44,612 45,551 6 -2 Diagnostics Division 14,104 17,730 -13 -20 Core operating profit 19,240 22,173 -1 -13 Core EPS – diluted (CHF) 18.57 20.30 6 -9 IFRS net income 12,358 13,531 7 -9 Roche CEO Thomas Schinecker: “We achieved good sales growth that more than offset the sharp drop in COVID-19 sales. Roche’s base business – excluding COVID-19 – continued its strong growth momentum with +8% at constant exchange rates. As a result, we exceeded our guidance for 2023. At the same time, the significant appreciation of the Swiss franc versus most currencies strongly impacted results when reported in Swiss francs. We also made good progress in both our pharma and diagnostics product pipeline. One recent highlight is inavolisib, an oral therapy investigated in phase III trials which showed a reduction of more than 50% in the risk of death or worsening disease for patients suffering from advanced, hard-to-treat breast cancer. We look forward to bringing this medicine to patients as soon as possible. Our new partnerships and acquisitions address disease areas with high unmet needs, such as inflammatory bowel disease and cardiometabolic disease. We are well positioned for future growth.” Change in Board of DirectorsBernard Poussot (born 1952), who has been a member of the Board of Directors since 2015, has decided not to stand for re-election at the Annual General Meeting in 2024. All other members of the Board will be proposed for re-election. Severin Schwan, Chairman of the Board: “Bernard Poussot’s extensive leadership experience and profound knowledge of the pharmaceutical industry have resulted in significant contributions to Roche. I am sincerely thankful to him.” Group resultsIn 2023, Roche achieved sales growth of 1% (-7% in CHF) to CHF 58.7 billion, exceeding the company’s guidance for the year. This increase more than made up for the expected decline in COVID-19-related sales, amounting to CHF 4.3 billion, and the effects of biosimilar erosion on our cancer medicines MabThera/Rituxan, Herceptin and Avastin, which totalled CHF 1.1 billion – resulting in an overall impact of CHF 5.4 billion (at CER). The Swiss franc significantly appreciated versus most currencies, impacting results when reported in Swiss francs compared to constant exchange rates. Core operating profit was down 1% (-13% in CHF) to CHF 19.2 billion. The good sales performance and a return towards a pre-COVID-19 sales mix resulted in an improved gross margin. This was offset by continued investments in pharmaceutical research, development and launches of new products. Additionally, the patent settlement income in Japan in 2022 affected the growth rate in 2023. IFRS net income increased by 7% (-9% in CHF) to CHF 12.4 billion due to the increase in operating profit (IFRS) and lower income tax expenses. Core earnings per share rose by 6% (-9% in CHF), including the positive impact from the resolution of tax disputes in 2023. Sales in the Pharmaceuticals Division increased by 6% to CHF 44.6 billion, with newer medicines for severe diseases continuing their strong growth. The top five growth drivers – Vabysmo (severe eye diseases), Ocrevus (multiple sclerosis), Hemlibra (haemophilia A), Polivy (blood cancer) and Phesgo (breast cancer) – achieved total sales of CHF 14.8 billion. This represents a plus of CHF 4.3 billion at CER compared to 2022. Vabysmo, launched only in early 2022, reached sales of CHF 2.4 billion, and has become one of the best-selling medicines of Roche. In the United States, sales rose by 8%. Vabysmo, Ocrevus and Hemlibra were the main growth drivers. This increase was partly offset by declining sales of medicines with expired patents. Sales in Europe grew by 6%, with key contributions from Germany, France and the UK. The sales growth of Vabysmo, Phesgo, Evrysdi (spinal muscular atrophy), Hemlibra and Ocrevus more than compensated for the lower sales of Ronapreve (COVID-19) and medicines with expired patents. In Japan, sales were down by 14%, mainly due to lower supply of Ronapreve to the government. Excluding Ronapreve, sales in Japan grew by 6%. This increase was fueled by the strong performance of newer medicines such as Polivy and Vabysmo, which effectively compensated for the impact of biosimilars. Sales in the International region grew by 13%, led by China, Brazil and Canada. In China, sales rose by 6%, with Tamiflu (influenza), Xofluza (influenza) and the cancer medicines Polivy, Tecentriq and Perjeta being the key growth drivers, more than offsetting the impact of biosimilars and lower sales of CellCept (transplantation). The Diagnostics Division’s base business sales increased by 7%, with immunodiagnostic products, particularly cardiac tests, and diagnostics solutions for clinical chemistry and for advanced staining contributing significantly to this growth. Overall, the Diagnostics Division reported sales of CHF 14.1 billion, a decline of 13%. This reflects the anticipated significant drop in demand for COVID-19-related products (sales of CHF 0.8 billion in 2023, compared to sales of CHF 4.1 billion in 2022, both at CER). With lower demand for COVID-19 testing, sales in the North America, EMEA and Asia-Pacific regions decreased by 21%, 13% and 11%, respectively. The division's base business grew across all regions. Pharmaceuticals Division: pipelineWith 82 new molecular entities (NMEs) and a total of 146 projects, Roche has a promising pipeline with a wide variety of therapeutic approaches. Pharmaceuticals research and development (R&D) expenditure grew by 6% to CHF 11.5 billion (Group R&D: +5% to CHF 13.2 billion). Oncology remained the primary area for R&D and cancer immunotherapy a key driver. Additionally, substantial investments were also made in neuroscience, ophthalmology and immunology. Pharmaceuticals: key milestones in the fourth quarter of 2023(incl. January 2024*) Compound Milestone Regulatory Tecentriq SC*Subcutaneous cancer immunotherapy EU approves Tecentriq SC, the EU’s first subcutaneous anti-PD-(L)1 cancer immunotherapy injection for multiple cancer types Subcutaneous (SC) injection offers the potential for a faster, more convenient alternative to intravenous (IV) infusion and is preferred by cancer patients, nurses and physiciansTecentriq SC reduces the time required to administer the treatment by approximately 80%, compared with standard IV infusionRoche is working closely with national health systems in Europe to ensure patients can access Tecentriq SC as quickly as possible More information: Media Release, 16 January 2024 Xolair Food allergies Based on positive National Institutes of Health phase III study results, FDA grants priority review to Xolair for children and adults with food allergies If approved, Xolair would be the first medicine to reduce allergic reactions to multiple foods following accidental exposureInterim analysis results from first-of-its-kind phase III OUtMATCH study showed that Xolair significantly increased the amount of peanut, milk, egg and cashew which it took to cause an allergic reactionIn the United States 17 million people have confirmed food allergies, and more than 40% of children and over 50% of adults with food allergies have experienced a severe reaction at least once in their lifetime More information: Media Release, 19 December 2023 VabysmoSevere eye diseases FDA approves Vabysmo for the treatment of retinal vein occlusion (RVO) RVO is the third indication for Vabysmo, in addition to neovascular or ‘wet’ age-related macular degeneration and diabetic macular oedemaApproval is based on two phase III studies demonstrating early and sustained vision improvements that were non-inferior to afliberceptVabysmo also demonstrated rapid and robust drying of retinal fluid More information: Media Release, 27 October 2023 Phase III, pivotal and other key readouts; data presentations; acquisitions and partnerships ColumviBlood cancer Lunsumio Blood cancer New data for Columvi and Lunsumio presented at the annual meeting of the American Society of Hematology (ASH) 2023 support continued benefit for people with lymphoma Longer-term data from pivotal studies of fixed-duration Columvi and Lunsumio continue to show durable responses in people with heavily pre-treated lymphomasNew data reinforce the potential of combination regimens in earlier treatment settings and add to the robust body of evidence supporting ongoing phase III studies More information: Media Release, 11 December 2023 Hemlibra Haemophilia A New data reinforce the benefit of early preventative treatment with Hemlibra for babies with severe haemophilia A Phase III HAVEN 7 primary data presented at the ASH annual meeting 2023 provide additional confidence in the favourable efficacy and safety profile of subcutaneous Hemlibra given soon after birthAt nearly two years median follow-up in the descriptive, single-arm study, no babies experienced spontaneous bleeds requiring treatment, and all treated bleeds were a result of traumaSafety results were consistent with previous studies of Hemlibra, with no new safety signals observedThe HAVEN 7 study was developed in collaboration with the haemophilia A community to generate additional evidence for the prophylactic treatment of infants with haemophilia A More information: Media Release, 9 December 2023 KadcylaBreast cancer Kadcyla is the first targeted therapy to show significant overall survival benefit in people with HER2-positive early-stage breast cancer with residual invasive disease after neoadjuvant treatment Phase III KATHERINE results reinforce Kadcyla as the standard of care for this population, with more than 82,000 people treated to dateLong-term data also showed continued benefit in invasive disease-free survival for adjuvant Kadcyla compared to Herceptin in this studyThese data were presented orally at the 2023 San Antonio Breast Cancer Symposium (SABCS) and included in the official press programme More information: Media Release, 8 December 2023 InavolisibBreast cancer Inavolisib combination reduces the risk of disease progression by 57% in people with advanced hormone receptor-positive, HER2-negative breast cancer with a PIK3CA mutation Inavolisib, an investigational oral therapy, in combination with palbociclib and fulvestrant more than doubled progression-free survival compared to palbociclib and fulvestrant aloneThe inavolisib combination has the potential to address resistance to treatment and poor prognosis associated with PIK3CA mutationsThese new data were presented orally at the 2023 SABCS and shared with health authorities More information: Media Release, 8 December 2023 Carmot:CT-388 and CT-996ObesityCT-868Diabetes type 1 Roche enters into a definitive merger agreement to acquire Carmot Therapeutics, whose portfolio includes three clinical-stage assets with best-in-class potential in obesity and diabetes Carmot Therapeutics’s research and development portfolio of clinical-stage incretins has great potential to treat obesity, diabetes and potentially other diseases both as stand-alone medicines and in combination with Roche’s in-house assetsLead asset CT-388 is a phase II-ready dual GLP-1/GIP receptor agonist with best-in-class potential for the treatment of obesity and its comorbiditiesUnder the terms of the agreement, Roche will pay a purchase price of USD 2.7 billion upfront and additional milestone payments of up to USD 400 million More information: Media Release, 4 December 2023 ElevidysDuchenne muscular dystrophy EMBARK trial in Duchenne muscular dystrophy (DMD) does not reach primary endpoint but shows positive efficacy outcomes on all timed functional key endpoints Boys aged 4–7 years with DMD who were treated with Elevidys showed an increase on the North Star Ambulatory Assessment (NSAA), a measure of motor function, compared to placebo at 52 weeks, but the primary endpoint was not metFor all key pre-specified secondary functional endpoints, including time to rise and 10-metre walk test across age groups, clinically meaningful and statistically significant treatment benefits were observedNo new safety signals were observed, reinforcing the favourable and manageable safety profile observed with Elevidys to date More information: Media Release, 30 October 2023 Telavant:RVT-3101Inflammatory bowel disease Roche entered into a definitive agreement to acquire Telavant including rights to novel TL1A-directed antibody (RVT-3101) for the treatment of inflammatory bowel disease from Roivant Roche obtained the rights to develop, manufacture and commercialise RVT-3101 in the US and Japan for the treatment of inflammatory bowel disease and potentially multiple other diseasesRVT-3101 is a phase III-ready antibody with first-in-class and best-in-disease potential, a novel mode of action and strong phase IIb data in ulcerative colitisRoche obtained an option to enter into a global collaboration with Pfizer on a next-generation p40/TL1A directed bispecific antibody, currently in phase IUnder the terms of the agreement, Roche paid a purchase price of USD 7.1 billion upfront and will pay a near-term milestone payment of USD 150 million More information: Media Release, 23 October 2023 Other Roche Group news Sustainability Roche and Chugai named among top three most sustainable healthcare companies in the Dow Jones Sustainability Indices (DJSI) The ranking acknowledges Roche’s commitment to sustainability as an integral part of its business strategyRoche performed particularly well in innovation management, access to healthcare, greenhouse gas emissions, water management, resource efficiency and circularity, labour practice indicators and human rightsThis marks the 15th consecutive year that Roche has maintained its leading rankingRoche ranked third, Chugai Pharmaceuticals, a member of the Roche Group, ranked second More information: Media Release, 15 December 2023 Pharmaceuticals sales Sales CHF millions As % of sales % change January–December 2023 2023 2022 2023 2022 At CER In CHF Pharmaceuticals Division 44,612 45,551 100.0 100.0 6 -2 United States 23,606 23,322 52.9 51.2 8 1 Europe 8,306 8,143 18.6 17.8 6 2 Japan 3,745 4,949 8.4 10.9 -14 -24 International* 8,955 9,137 20.1 20.1 13 -2 *Asia-Pacific, CEETRIS (Central Eastern Europe, Türkiye, Russia and Indian subcontinent), Latin America, Middle East, Africa, Canada, others Top 20 best-selling pharmaceuticals Total United States Europe Japan International CHF m % CHF m % CHF m % CHF m % CHF m % OcrevusMultiple sclerosis 6,381 13 4,684 11 1,166 12 - - 531 31 HemlibraHaemophilia A 4,147 16 2,493 14 845 18 373 12 436 29 Perjeta2Breast cancer 3,768 1 1,336 -7** 776 -8 215 4 1,441 16 TecentriqCancer immunotherapy 3,766 9 1,941 4 845 10 419 8 561 29 Actemra/RoActemra2RA, COVID-19 2,630 5 1,223 9 775 0 311 3 321 4 VabysmoEye diseases (nAMD, DME, RVO) 2,357 324 1,914 293 276 *** 98 138 69 *** Xolair2Asthma 2,176 5 2,176 5 - - - - - - Kadcyla2Breast cancer 1,966 4 757 -2 577 -11 102 -12 530 43 MabThera/Rituxan2Blood cancer, RA 1,630 -15 987 -20 180 -9 24 -13 439 -6 Herceptin2Breast and gastric cancer 1,626 -16 331 -26 353 -14 30 -33 912 -13 Avastin2Various cancer types 1,573 -19 484 -19 98 -47 318 -26 673 -7 AlecensaLung cancer 1,502 8 467 9 292 4 212 5 531 11 EvrysdiSpinal muscular atrophy 1,419 39 505 14 509 49 93 26 312 80 Activase/TNKaseCardiac diseases 1,173 6 1,112 6 - - - - 61 5 PhesgoBreast cancer 1,120 64 423 48 534 52 4 - 159 189 PolivyBlood cancer 837 108 340 119 173 36 227 129 97 317 Gazyva/Gazyvaro2Blood cancer 811 19 395 22 229 24 38 -14 149 18 RonapreveCOVID-19 525 -65 - - 5 -95 519 -60 1 -99 LucentisEye diseases 460 -52 460 -52 - - - - - - PulmozymeCystic fibrosis 452 -10 303 -13 76 -18 1 8 72 9 ** Perjeta sales decline in the US mainly resulted from an adjustment related to government programmes. Excluding this adjustment, Perjeta sales in the US showed a growth of 1%.*** Over 500%DME: diabetic macular oedema / nAMD: neovascular or ‘wet’ age-related macular degeneration / RVO: retinal vein occlusion / RA: rheumatoid arthritis Diagnostics: key milestones in the fourth quarter of 2023 Product Milestone Elecsys HBeAg quantHepatitis B Roche expands hepatitis diagnostics portfolio to help clinicians diagnose and monitor patients with acute or chronic hepatitis B infection Elecsys HBeAg quant is an immunoassay that can be used as an early marker of acute hepatitis B infection, as well as an indicator of chronic active hepatitis in combination with other laboratory results and clinical informationThe single test will inform clinicians if treatment is required and regimens are working together with other diagnostic assaysAlmost 300 million people globally have chronic hepatitis B, causing a significant burden to health systems as it puts patients at high risk of death from cirrhosis and liver cancer More information: Media Release, 27 November 2023 Elecsys Anti-HEV IgM and Elecsys Anti-HEV IgGHepatitis E Roche launches automated serology hepatitis E virus tests, including a test to detect acute HEV infections, recommended in the new WHO 2023 Essential Diagnostics List It is estimated that one third of the global population could be at risk for infection with hepatitis E virusThe new tests allow clinicians to diagnose acute and chronic infections amongst patients presenting with or without signs of the illness as recommended by the European Association for the Study of the Liver (EASL)The tests complete Roche’s panel used for the differential diagnosis of acute viral hepatitis caused by the hepatitis A, B, C and E viruses More information: Media Release, 16 November 2023 Elecsys NfL testMultiple sclerosis FDA grants Breakthrough Device Designation for Elecsys NfL test, an important aid for those living with multiple sclerosis Elecsys NfL aids in detection of disease activity in adults with multiple sclerosis, supporting better disease management decisionsElecsys NfL offers a minimally invasive testing option that can provide rapid answers to patients and caregiversElecsys NfL has the potential to provide patient insights for other neurological conditions such as Alzheimer’s and Huntington’s diseases More information: Media Release, 9 November 2023 Other Diagnostics news LumiraDxPoint-of-care technology platform Roche enters into a definitive agreement to acquire LumiraDx’s point-of-care technology combining multiple diagnostic modalities on a single platform The transformative point-of-care solution will complement Roche’s centralised diagnostics portfolio across clinical chemistry, immunochemistry, coagulation and molecular diagnostics, and across multiple disease areasLumiraDx’s technology integrates multiple point-of-care tests on a simple-to-use single instrument and brings more affordable and accessible testing to patients worldwideUnder the terms of the agreement, Roche will pay a purchase price of USD 295 million and an additional payment of up to USD 55 million More information: Media Release, 29 December 2023 Diagnostics sales Sales CHF millions As % of sales % change January–December 2023 2023 2022 2023 2022 At CER In CHF Diagnostics Division 14,104 17,730 100.0 100.0 -13 -20 Customer Areas3 Core Lab 7,750 7,775 55.0 43.9 9 0 Molecular Lab 2,220 3,450 15.7 19.5 -30 -36 Pathology Lab 1,388 1,318 9.8 7.4 14 5 Point of Care 1,379 3,589 9.8 20.2 -58 -62 Diabetes Care 1,367 1,598 9.7 9.0 -4 -14 Regions Europe, Middle East, Africa 4,768 5,888 33.8 33.2 -13 -19 North America 3,826 5,141 27.1 29.0 -21 -26 Asia–Pacific 4,496 5,639 31.9 31.8 -11 -20 Latin America 1,014 1,062 7.2 6.0 14 -5 More information on Roche performance in 2023: Full-Year 2023 Finance Report Full-Year 2023 Annual ReportFull-Year 2023 PresentationAppendix with Tables About Roche Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice. In recognising our endeavour to pursue a long-term perspective in all we do, Roche has been named one of the most sustainable companies in the pharmaceuticals industry by the Dow Jones Sustainability Indices for the fifteenth consecutive year. This distinction also reflects our efforts to improve access to healthcare together with local partners in every country we work. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. For more information, please visit www.roche.com. All trademarks used or mentioned in this release are protected by law.References[1] Unless otherwise stated, all growth rates and comparisons to the previous year in this document are at constant exchange rates (CER: average rates 2022) and all total figures quoted are reported in CHF.[2] Products launched before 2015. [3] Core Lab: diagnostics solutions in the areas of immunoassays, clinical chemistry and CustomBiotech.Point of Care: diagnostics solutions in emergency rooms, medical practices or directly with patients. Molecular Lab: diagnostics solutions for pathogen detection and monitoring, donor screening, sexual health and genomics. Diabetes Care: integrated personalised diabetes management. Pathology Lab: diagnostics solutions for tissue biopsies and companion diagnostics. Cautionary statement regarding forward-looking statementsThis document contains certain forward-looking statements. These forward-looking statements may be identified by words such as ‘believes’, ‘expects’, ‘anticipates’, ‘projects’, ‘intends’, ‘should’, ‘seeks’, ‘estimates’, ‘future’ or similar expressions or by discussion of, among other things, strategy, goals, plans or intentions. Various factors may cause actual results to differ materially in the future from those reflected in forward-looking statements contained in this document, such as: (1) pricing and product initiatives of competitors; (2) legislative and regulatory developments and economic conditions; (3) delay or inability in obtaining regulatory approvals or bringing products to market; (4) fluctuations in currency exchange rates and general financial market conditions; (5) uncertainties in the discovery, development or marketing of new products or new uses of existing products, including without limitation negative results of clinical trials or research projects, unexpected side effects of pipeline or marketed products; (6) increased government pricing pressures; (7) interruptions in production; (8) loss of or inability to obtain adequate protection for intellectual property rights; (9) litigation; (10) loss of key executives or other employees; and (11) adverse publicity and news coverage. The statement regarding earnings per share growth is not a profit forecast and should not be interpreted to mean that Roche’s earnings or earnings per share for this or any subsequent period will necessarily match or exceed the historical published earnings or earnings per share of Roche. Roche Global Media RelationsPhone: +41 61 688 8888 / e-mail: media.relations@roche.com Hans Trees, PhDPhone: +41 79 407 72 58 Nathalie AltermattPhone: +41 79 771 05 25 Simon GoldsboroughPhone: +44 797 32 72 915 Karsten KleinePhone: +41 79 461 86 83 Nina MählitzPhone: +41 79 327 54 74 Kirti PandeyPhone: +49 172 6367262 Dr. Rebekka SchnellPhone: +41 79 205 27 03 Sileia UrechPhone: +41 79 935 81 48 Attachments 01022024_MR_Roche FY 2023_en Communications appendix tables_FY 2023_Sales & Results

Clinical ResultPhase 3Phase 2Breakthrough TherapyDrug Approval

100 Deals associated with Tenecteplase

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KEGG	Wiki	ATC	Drug Bank
D06070	Tenecteplase	B01AD11	DB00031

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Acute myocardial infarction	US	Genentech, Inc.	02 Jun 2000

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Acute Ischemic Stroke	NDA/BLA	EU	Boehringer Ingelheim International GmbH	14 Dec 2023
occlusions	Phase 3	BR	Boehringer Ingelheim GmbH	20 Jan 2022
Stroke	Phase 3	US	Genentech, Inc.	02 Mar 2019
Stroke	Phase 3	CA	Genentech, Inc.	02 Mar 2019
Thrombosis	Phase 3	US	Genentech, Inc.	02 Mar 2019
Thrombosis	Phase 3	CA	Genentech, Inc.	02 Mar 2019
Pulmonary Embolism	Phase 3	AT	Boehringer Ingelheim GmbH	16 Nov 2007
Pulmonary Embolism	Phase 3	BE	Boehringer Ingelheim GmbH	16 Nov 2007
Pulmonary Embolism	Phase 3	FR	Boehringer Ingelheim GmbH	16 Nov 2007
Pulmonary Embolism	Phase 3	DE	Boehringer Ingelheim GmbH	16 Nov 2007

Clinical Result

Indication

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03785678 (TIMELESS, CTgov)	Phase 3	Thrombosis \| Stroke	458	Tenecteplase (Tenecteplase)	khwgbepshz(bajageoepv) = wutoszejbv nnvzlzrzig (wsbvgytrfm, wrutgxuesd - hnsspfmkpc) View more	-	22 May 2024
				Placebo (Placebo)	khwgbepshz(bajageoepv) = bdmjtmoinf nnvzlzrzig (wsbvgytrfm, ilfotnrevh - gzgbvdzrbv) View more
ANA2023	Not Applicable	Stroke	130	Tenecteplase	orhjvzlrjn(wkkuubbkxs) = ljlymokkaq bqcnluayqh (lrpyozduej )	Positive	01 Sep 2023
				Alteplase	orhjvzlrjn(wkkuubbkxs) = vvbwmtiqxh bqcnluayqh (lrpyozduej )
ANA2023	Not Applicable	Acute Ischemic Stroke	148	Tenecteplase (TNK)	legrzswtin(udkpewqlea) = noqmvjfxgl nfwyaanuwb (novgedimus ) View more	Positive	01 Sep 2023
				Alteplase (tPA)	legrzswtin(udkpewqlea) = khalarshry nfwyaanuwb (novgedimus ) View more
AAN2023	Not Applicable	Acute Ischemic Stroke	4,140	Tenecteplase 0.25 mg/kg	cxvldwhylk(mpwcewouhj): RR = 1.53 (95% CI, 1.03 - 2.26) View more	-	25 Apr 2023
				Alteplase
P8-5.005 (AAN2023)	Not Applicable	Acute Ischemic Stroke	-	Tenecteplase	yoizdqejhl(nltvskawlq) = hwksxjbuly cbnfxbdqop (yvwaidqwlw ) View more	Positive	25 Apr 2023
				Alteplase	yoizdqejhl(nltvskawlq) = wmevwtbejc cbnfxbdqop (yvwaidqwlw ) View more
NCT04505592 (CTgov)	Phase 2	COVID-19 \| Respiratory Failure \| Respiratory Distress Syndrome, Adult	13	Tenecteplase (Tenecteplase)	aqjvvfiaby(aolqvlcqjv) = hwnvyznseo uvcuyqvjjj (bhyesktrpn, uqpievxgyu - eyjqfgdvhz) View more	-	06 Apr 2023
				Placebo (Placebo)	aqjvvfiaby(aolqvlcqjv) = bsrmnxutjk uvcuyqvjjj (bhyesktrpn, beuqivrvmi - diynspkwna) View more
ISC2023	Not Applicable	Ischemic stroke	127	Alteplase	eeqbaomhrp(scnfxzxyzc) = exfnjmjlme ctlqkzcknl (dmvhutdonf ) View more	Positive	01 Feb 2023
				Tenecteplase	eeqbaomhrp(scnfxzxyzc) = fxqwkritkw ctlqkzcknl (dmvhutdonf ) View more
ISC2023	Not Applicable	-	77	Tenecteplase	vogyqyoowd(eulmpfbdpq) = yihglwswef nzulrmnboy (qfnfqztbci )	-	01 Feb 2023
ISC2023	Not Applicable	Acute Ischemic Stroke	180	Tenecteplase	mgueucynpm(vxmltqkdnd) = spyfbbfyri xnfszurywz (pkdmbfygot ) View more	Negative	01 Feb 2023
ISC2023	Not Applicable	-	191	Tenecteplase	lxmyueqwpz(fcujxhovyj) = gggfmibonn wtmviorpve (qxtbdmayzx ) View more	-	01 Feb 2023
				Alteplase	lxmyueqwpz(fcujxhovyj) = cxwkzczrtl wtmviorpve (qxtbdmayzx ) View more

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