TAME-ing aging

Alzheimer’s, cancer, heart disease, and other serious illnesses share a single common risk factor: aging. Drugs that slow or reverse key features of aging biology might help not just one but many age-related diseases.

The prospect of a pill that could delay or prevent the onset of multiple age-related diseases may seem like a dream, but it’s one step closer to becoming a reality with a recent announcement by the US FDA. It has given the greenlight for scientists to test the diabetes drug metformin in older adults with the goal of forestalling these and other diseases.

A group of scientists, led by Dr. Nir Barzilai at Albert Einstein College of Medicine, recently announced they are seeking funding for a clinical trial—the first of its kind— aimed at delaying and preventing many diseases associated with old age. The TAME trial (or Targeting Aging with Metformin) will test the drug metformin in older adults who either have cancer, heart disease or cognitive impairment or are at risk for these diseases. The goal is to treat 3,000 volunteers aged 70 to 80 years for 5 to 7 years and see if their development of other diseases is delayed. If successful, this would be the first demonstration in humans that a single drug can delay the onset of multiple age-related diseases and, indeed, may indicate that metformin actually slows human aging.

Metformin has been in use for 60 years to treat diabetes. It has a good safety record and is the first-line treatment for type II diabetes. It works by reducing glucose production in the liver and increasing the body’s sensitivity to insulin. Metformin extends lifespan and lowers the risk of age-related diseases in experimental mice, worms and flies [1]. And preliminary results from human observational studies suggest people with diabetes who take metformin may see similar benefits [2].

If you’re thinking of taking a dip in the fountain of youth, don’t put on your swim suit just yet. Almost all the evidence for benefit has come, so far, from people with type II diabetes. We don’t yet know if people without that disease will show similar results. But even if metformin doesn’t have wider benefits, the TAME trial could pave the way for testing other, more effective drugs for aging. It signals FDA recognition that targeting aging biology is a valid approach to protect against a variety of age-related diseases, which in turn could spur much-needed research into new drugs to slow age-related processes.

For now, though, the researchers still need to raise about $50 million, no small task considering metformin is a generic drug, which often lessens investment enthusiasm by pharmaceutical companies. If the trial does move forward and is successful, it may well change how we think about and treat age-related diseases. Even if we can’t swim laps in the fountain of youth, maybe we can still dip our toes in.

References:

1) Anisimov, VN. Metformin: do we finally have an anti-aging drug? Cell Cycle 2013: 12(22):3483-9.

2) Bannister, CA, et al. Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic controls. Diabetes Obes Metab 2014: 16(11):1165-73.

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