Dr. Nir Barzilai, serving as the director of the Institute for Aging Research at the Albert Einstein College of Medicine and scientific director at The American Federation for Aging Research (AFAR), anticipates that it will take several decades before gerotherapeutics—that are effective in combating the aging process—become widely accessible. He suggests that the focus should be on identifying safe and effective medications that address aging mechanisms such as inflammation and cellular damage.
During an interview with Fortune at the Longevity Investors Conference in Gstaad, Switzerland, Barzilai emphasized the importance of obtaining evidence from clinical trials rather than from anecdotal reports or animal studies. He warned against falling for unfounded claims and encouraged scrutiny, advising people to ask for clinical study data when presented with exciting new findings.
According to Barzilai, successful gerotherapy should achieve four objectives: it should address the key signs of aging, extend the health span by reducing disease risk late in life, undergo rigorous safety and efficacy testing in large-scale clinical trials, and influence overall mortality rates.
Despite progress in geroscience, Barzilai notes that out of four FDA-approved drugs showing promise in targeting the aging process, none are specifically approved as anti-aging treatments. These drugs, however, rank highly on his 12-point scale for assessing longevity potential.
Some of the drugs have been shown to reduce hospitalization, death, and complications from long COVID, indicating potential benefits beyond their intended uses for conditions like diabetes, as noted by Barzilai at the Longevity Investors Conference. He suggests these drugs might enhance the body’s resilience to severe diseases.
The drugs under consideration are:
GLP-1s: This class, including Ozempic and Wegovy, initially developed for diabetes, also shows potential in reducing obesity, heart disease, kidney disease, Parkinson’s, and Alzheimer’s. Barzilai assigns them a score of 10 out of 12 for their potential in targeting aging mechanisms. Dr. Douglas Vaughan from Northwestern University highlights extensive animal research showing calorie restriction as effective in life extension, a mechanism GLP-1s may influence through appetite suppression and improved blood sugar levels.
SGLT2 Inhibitors: These are the only drugs on the list receiving a perfect score on Barzilai’s scale. Typically used to manage type 2 diabetes by reducing blood sugar through urine excretion, they also show promise in reducing oxidative stress and inflammation, potentially lowering risks for age-related diseases and even dementia in long-term use.
Bisphosphonates: With a score of 11 out of 12, these drugs are prescribed for osteoporosis, affecting millions of Americans. They have transformed the treatment of skeletal disorders and observational studies suggest they also reduce mortality rates.
Metformin: As the most prescribed diabetes medicine, it’s noted for targeting common aging hallmarks like cellular senescence by protecting DNA, reducing inflammation, and improving insulin sensitivity. However, its anti-aging effects in non-diabetic individuals require further research.
While these drugs may influence aging mechanisms, none are approved solely for anti-aging, and their use is generally limited to patients already experiencing certain health conditions. Barzilai stresses the importance of understanding patient-specific contraindications and side effects.
Dr. Barzilai advises individuals to consult healthcare providers regarding health status and potential drug interactions to determine suitability. He emphasizes that lifestyle changes (exercise, diet, sleep, and social connectivity) remain fundamental for healthy aging, though medication advancements may further extend lifespan beyond lifestyle alone.