Comparing different doses of tenecteplase for treating acute ischemic stroke

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

Phase 3 Interventional University of Calgary · NCT06320431

This study is testing whether a standard dose or a lower dose of a medication called tenecteplase can help people who have had an acute ischemic stroke recover better and stay safe.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment4000 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity of Calgary Academic / other
Locations24 sites (Sydney, Barangaroo and 23 other locations)
Trial IDNCT06320431 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to evaluate the effectiveness of standard-dose versus low-dose intravenous tenecteplase in patients with acute ischemic stroke. It employs a randomized, controlled, open-label design with blinded endpoint assessment, enrolling up to 4,000 patients who present to hospitals within 4.5 hours of symptom onset. Participants will be followed for 90 days to assess outcomes related to stroke recovery and safety. The trial also investigates the use of tenecteplase in conjunction with endovascular thrombectomy when necessary.

Who should consider this trial

Good fit: Ideal candidates include patients with disabling acute ischemic stroke who present within 4.5 hours of symptom onset and may benefit from intravenous thrombolysis.

Not a fit: Patients with absolute contraindications for intravenous thrombolysis or those experiencing minor strokes with non-disabling symptoms may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to optimized dosing of tenecteplase, improving recovery outcomes for patients with acute ischemic stroke.

How similar studies have performed: Previous studies have shown promising results with tenecteplase, indicating its potential efficacy compared to alteplase, making this approach both relevant and timely.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. All patients with disabling AIS presenting within 4.5 hours of symptom onset or last known well who may benefit from intravenous thrombolysis (IVT) with tenecteplase. Patients potentially eligible for IVT with conditions described as relative contraindications in national guidelines where physician discretion is recommended are eligible. Patients who received a DOAC, and those planned for emergency EVT are eligible.
2. Consent process completed as per national laws and regulation and the applicable ethics committee requirements.

Exclusion Criteria:

1. Any absolute contraindication for IV thrombolysis per current national guidelines. Examples include those who are actively bleeding, had recent intracranial surgery, head trauma, intracranial or subarachnoid hemorrhage, or a bleeding diathesis.
2. Minor stroke patients with non-disabling symptoms.

Where this trial is running

Sydney, Barangaroo and 23 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Acute Ischemic Stroke AISStroke AcuteStroke, Acute, Stroke IschemicStrokeThrombolysisPlatformTenecteplaseEndovascular thrombectomy
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.