Whenever anyone starts thinking that only they have the “one truth”, it greatly raises my skepticism alarms.
The simple truth is that biology is extremely complex. The list of things that “seem good” in early testing, but later prove to be harmful, is long.
In my view, humility and recognition that there is a more than reasonable chance that any of us is wrong on something we believe is “true”, is probably a helpful thing to keep in mind.
And, when people spend their academic lives in medical school and have years of clinical experience I tend to give them a lot more weight than my (or other layman’s) cursory review of some research papers and popular science articles. Of course, doctors and PHDs are all humans, they make mistakes like all of us… but any medical professional or PHD participating here should, I think, be considered “one of the good guys” who is very interested in longevity and the latest science in this area, so my immediate predisposition is that we welcome and appreciate their input.
We’re all here with the recognition that there is a large “grey area” in the longevity data for all the drugs and supplements we are taking or considering taking.
I believe we move forward when we are most clear-eyed in our reviews of our current and potential longevity agents. There is no one “truth”. The more data we have and the more we identify the potential risks and measurable benefits, the better we are are able to make decisions and risk-based assessments.
I think @KarlT and @AnUser provide valuable input here in this thread on potential risks, and I thank them for that. I think you, @Joseph , would benefit by also being thankful. Because they are bring up risks that we may not have considered, or have under-valued.
As I say frequently in these forums, go hard on the science, but go easy on the people. We are all trying to make decisions here based on imperfect information. The more thought and considerations from knowledgeable and thoughtful people we can bring to bear on the task at hand, the more we all benefit.
I really think we all need to be thinking that we are all working together to identify the best course of action, based on the data at hand, and our own personal health considerations, life considerations and personal risk profiles. And always be ready to change your mind based on new data.
And, this is an ongoing process that will go on for the foreseeable future…
I was just reading this article by an ex-pharma guy, and it reiterates the fact that we are all going to be in a very “gray area” as far as longevity drug knowledge goes, for a very long time…
This [longevity drugs and therapies] all sounds terrific. However, there is a major challenge for discovering and developing anti-aging drugs. How does one design a clinical trial to convince patients, physicians, payers and, especially, the FDA that a drug actually works?
To do this, a company would have to prove that its drug extends lives. You can’t test such a drug in young or even middle-aged people, as these groups still have considerable life left—assuming a life expectancy of 80 years. Thus, you would probably need to study the drug in healthy 70-year-olds (with a placebo control group as comparator) and then follow these subjects for a decade or more to see if those on the drug live meaningfully longer than those in the placebo group. In order to see a statistically meaningful longevity effect, however, the study would need a minimum of 20,000 subjects. This “outcomes” trial would be similar to what is now done for new drugs to treat heart disease, in which a drug’s efficacy is determined by whether it reduced heart attacks and strokes. Such studies are not cheap. The costs can be on the order of $2 billion.
Given these enormous challenges, why would anyone actually engage in anti-aging R&D drugs? After all, the people investing in these field are accomplished scientists and investors. They are aware of these challenges. Despite the hype around extending the human life span by 10 to 20 years, these companies will not look to conduct life extension studies right out of the gate. Rather, the first drugs will be tested against age-related diseases. For example, one company, Life Biosciences, hopes to use its work in epigenome reprogramming to treat strokes that occur in the back of the eye—a condition known as non-arteritic anterior ischemic optic neuropathy. While a new treatment for this disease would be welcomed, it is a far cry from adding a decade to the life expectancy of Baby Boomers.
So, when reading the hype about new scientific breakthroughs that offer the promise of the “Fountain of Youth,” admire the science. But keep in mind that it’s going to be a long while before such drugs are actually available.
John L. LaMattina is the former president of Pfizer Global R&D and the author of Pharma & Profits – Balancing Innovation, Medicine, and Drug Prices .)
