Curriculum
MODULE 07 · 60 min

Pharmacology of Healthspan

Rapamycin, metformin, GLP-1s, senolytics — what's real, what's investigational.

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Core summary

Some prescription drugs originally developed for diabetes or transplant patients show signs of slowing aging — but most haven't been proven for that purpose in healthy people. GLP-1 medications (Ozempic, Mounjaro) are reshaping medicine because they reduce weight, heart attacks, kidney decline, and possibly dementia. Don't take prescription drugs for longevity outside a clinical relationship.

Topics covered

  • 01Rapamycin (sirolimus): mTOR inhibition, ITP results, off-label dosing debate
  • 02Metformin: TAME trial design, MILES, biomarker effects
  • 03GLP-1 agonists: cardiovascular, renal, dementia signals
  • 04SGLT2 inhibitors and healthspan endpoints
  • 05Senolytics: dasatinib + quercetin, fisetin
  • 06Statins, ACEi, PCSK9 — established geroprotection through CV risk

Learning objectives

  • Summarize the ITP rapamycin lifespan results across replicates.
  • Critique the TAME trial design and its multi-morbidity endpoint.
  • Discuss GLP-1 receptor agonists' beyond-glycemic outcomes.
  • Differentiate evidence levels for senolytic candidates in humans.

Key takeaways

  • Rapamycin is the most replicated lifespan-extender in mice — human clinical use is off-label and uncertain.
  • Metformin's healthspan effects in non-diabetics remain unproven pending TAME.
  • GLP-1s are quietly the most consequential geroscience-relevant drug class of the decade.

Graded claims

A
Rapamycin extends lifespan in mice
Clinically establishedITP-replicated across sexes and start ages.
C
Metformin reduces all-cause mortality in non-diabetics
Promising, preliminaryTAME pending; observational signals mixed.
A
GLP-1 agonists reduce CV mortality in T2D and obesity
Clinically establishedSUSTAIN-6, SELECT, STEP trials.
D
Off-label rapamycin extends human healthspan
Plausible, unproven in humansPlausible; no RCT evidence yet.
F
Compounded peptide stacks are FDA-approved longevity therapies
Misleading or falseFDA has issued explicit warnings on compounded peptides.

Quick check

1. Rapamycin's primary molecular target is:
2. TAME trial's primary innovation was:
3. Best-evidenced senolytic combination in human pilots is:

Flashcards

Further reading

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