Low-Dose Tenecteplase for Acute Ischemic Stroke Treatment in Aging Patients DATE-AGING Trial: Rationale and Design

Abstract Background: Despite the high stroke burden in the elderly, their thrombolysis utilization is suboptimal partly due to heightened hemorrhagic risk.

By Zhou, Hou, Mi +10Oct 11, 2026

Score█████░░░░░4.8

Key numbers

4.5 hours of ischaemic stroke
4.5 hours of symptom onset
36 hours and mortality at

Caveats

Preprint; not yet peer reviewed.

VerdictWorth a reader's time today.

Read the original PDF

Abstract

Abstract Background: Despite the high stroke burden in the elderly, their thrombolysis utilization is suboptimal partly due to heightened hemorrhagic risk. Observational data suggest that low-dose thrombolysis may offer comparable efficacy to standard-dose with a trend toward reduced symptomatic intracranial hemorrhage (sICH), yet high-level evidence for low-dose thrombolysis in this broad population remains absent. Objective: To evaluate the safety and efficacy of low-dose intravenous tenecteplase thrombolysis in elderly stroke patients within 4.5 hours of ischaemic stroke onset. Methods and design: The DATE-AGING trial is a multicenter, prospective, randomized, open-label, blinded-end point (PROBE) non-inferiority study. Eligible participants are elderly patients (aged [≥]70 years)with acute ischemic stroke who meet current guideline recommendations for intravenous thrombolysis within 4.5 hours of symptom onset will be randomly assigned to Low-dose Tenecteplase group (0.175 mg/kg, max 17.5 mg) or Standard-dose Tenecteplase group (0.25 mg/kg, max 25 mg). The primary outcome was excellent functional outcome, defined as a mRS 0-1 assessed at 90-day post-randomization. Safety outcomes included sICH within 36 hours and mortality at 90 days. Discussions: The DATE-AGING trial is intended to provide high-quality evidence for low-dose tenecteplase intravenous thrombolysis in elderly patients with acute ischemic stroke. Trial registry number: NCT07294209(https://clinicaltrials.gov/study/07294209). Keywords: elderly patients, acute ischemic stroke, intravenous thrombolysis, low-dose tenecteplase

Z. Zhou, X. Hou, S. Mi, X. Chen, Y. He, L. Chen, Q. Liu, J. Wu, T. Lv, L. Kong, R. Xu, M. Wu, D. Wang

The editor's rubric

Heuristic review

Dimension	Level	Weight	What that level means
Leverage	██░░░ 2	10%	Reusable within one subfield (a technique, dataset, or protocol a few groups will adopt).
Magnitude	██░░░ 2	20%	Solid incremental gain on a meaningful problem.
Evidence	████░ 4	32%	Strong: large scale, preregistered, independently replicated, or a well-powered randomized trial.
Novelty	██░░░ 2	8%	A new combination of known ideas.
Trajectory	██░░░ 2	5%	Some room to improve with obvious engineering.
Stakes	███░░ 3	25%	Meaningful benefit to many people within a few years.

Editor’s rationale

Heuristic triage from title and abstract text only, not a reading of the paper. Cues found: novelty (open problem); design (randomized, blinded, registered); stakes (mortality, major disease, prevention or cure).

How the score was computed

rank-2026-10-07

Score█████░░░░░4.8

Score = 10 × (80% × adjusted merit / 10 + 10% × attention + 10% × freshness)

Merit: 5.8 / 10; Weighted rubric, evidence-gated.
Adjusted merit: 4.8 / 10; Shrunk toward the desk prior by editor confidence (46%).
Attention: 0%; Citations, upvotes, points, mentions.
Freshness: 92%; Half-life decay since publication.

Citations0 (reference 20, via semantic-scholar, Oct 12, 2026, 06:17 UTC)

The record

Reviewed by heuristic-v6 on Oct 12, 2026, 06:17 UTC. Paper type: clinical.
Categories: neurology
BRIEF, No.3 in the Medicine edition of October 12, 2026.