I’ve mentioned the proposed clinical trial with metformin as a general anti-aging therapy. Here’s a profile of Nir Barzilai, the principle investigator for it. Choosing metformin was as much about going in with a drug that has a very clean safety profile as anything else:
“There’s nothing we don’t know about metformin,” Barzilai says—especially its record for safety, which he calls “critical” to the proposed trial.
His colleagues agreed, sometimes reluctantly. “Rapamycin would have been my first choice, because the animal results have been so spectacular,” Austad says. “But Nir said, ‘We can’t afford in this first trial to kill anybody.’ And I thought, ‘Strategically, he’s right.’”
Barzilai concedes that he and the AFAR-sponsored group are as interested in setting a precedent as in scoring an impressive initial success. Satisfying FDA concerns about a trial that breaks tradition and measures multiple disease endpoints in an aging population, they say, will open the door for pharma to enter the field.
The meeting with the FDA was successful, in that the agency seems open to the idea of such a trial (which has not always been the case). Now comes the money. The team estimates that they’ll need about $50 million for the trial, and are open to public funding, private funding, whatever they can get. I hope that they can round it up, because this trial (and this whole area of research) are more important than you might think. If we can increase healthy lifespan, and compress the breakdowns of old age to a shorter period at the end, we could save trillions of dollars of health care costs without anyone having any grounds to feel cheated in any way (which is always the problem with trying to squeeze money out of the system as it is). On the other hand, giving people an extra five years of decrepitude would be a financial (and human) disaster.
Which of those will it be with metformin, or the other possible therapies? There’s only one way to find out. That’s what the drug business comes down to, in the end, the fact that the only way to really be sure what will happen in people is to give the drug to people and see.