Can pharma deliver a cure for ageing?

Rich Quelch, global head of marketing at Origin examines the rise of senolytics and what pharma is doing to combat ageing. 

Humans have always been fascinated with life, death and immortality. The quest to stop or even reverse the biological process of ageing has never ceased despite no real progress being made for years. 

Yes, there have been plenty of scientific breakthroughs to help people live healthier for longer and as a result, the maximum lifespan has been increasing for almost 150 years now. But the powers of modern medicine inevitably reached a plateau. Until now.

Approaching ageing from a cellular level, scientists are discovering how to stop the process of senescence (widely accepted as contributing to ageing) through medicinal means. But we’re still a long way off commercialisation and understanding the complexities of extending the natural limit of how long humans can live on a mass scale.

The rise and rise of the longevity industry

People in most of the developed world are living longer than ever. Looking at the UK specifically, the Office for National Statistics predicts the population of over-65-year-olds will increase by 8.6 million in the next 50 years.

While this is very positive to see, an ageing population throws up huge challenges for healthcare, economic and social systems. 

Currently, the leading causes of death worldwide are age-related illnesses like cardiovascular diseases, cancer, and neurodegenerative diseases such as Alzheimer’s. If this trend can be reversed and people can live for longer without the need for clinical care, the impact would be huge.

In response to the question of how to help more people live longer but healthier, the so-called “Longevity Industry” has exploded with many Silicon Valley giants like Facebook and Alphabet investing billions. As an industry, it’s already estimated to be worth $200 billion globally.

Innovations in age-tech are happening everyday but the pathology behind ageing is still largely an enigma to the scientific community. But the tide seems to be turning and we may have just unlocked the key.

A medical cure for ageing?

Senotherapy, an early-stage scientific field, is the next big thing in anti-ageing research.

It approaches ageing from a cellular level and is born out of the understanding that as cells in the human body age they enter a state known as senescence which results in the loss of a cell's power to divide and grow. 

Over time, this spreads to more and more cells which inhibits the body’s ability to repair tissue, control inflammation and protect against age-related diseases. The more senescent cells a person accumulates, it seems the faster their biological clock ticks.

The scientific community is currently making promising progress in their exploration of whether the process of senescence can be therapeutically targeted to help to slow or even halt it altogether. As the median age for cancer, Alzheimer's, Parkinson’s and other age-related diseases is high (60+), understanding their pathology can reveal new insights into what mechanisms also cause ageing.

For example, neurodegenerative diseases (NDDs) share cellular and molecular mechanisms commonly seen in ageing cells such as inflammation, mitochondrial dysfunction and oxidative stress.

The first in-human trial of senolytics recently took place and the results were promising. As with mice, these drugs were successful in removing senescent cells in people. Specifically, the administration of senolytics improved the physical function in patients with idiopathic pulmonary fibrosis (IPF), a fatal senescence-associated disease where the lungs become scarred and breathing becomes increasingly difficult.

The complexities of healthy ageing

If senolytics reach the stage of commercialisation and offer a legitimate way of helping more people live healthier for longer, there is an important debate to be had about the consequences of intervening in one of life’s most fundamental and inevitable processes – death.

The longevity industry is highly complex; a space where many industries overlap and intersect, requiring synergy and collaboration between pharma, technology, finance, health and social care, government departments, bodies and agencies, and political parties. No easy feat. 

In this diverse and dynamic field, creating concrete understanding amongst all partners and making accurate forecasts will be hugely challenging particularly given the rapid pace at which age-tech is evolving.

At present, there exists a severe shortage of geriatricians with the clinical understanding and experience to lead the first round of clinical trials to determine if these emerging interventions are effective and safe. 

Until this skills gap is closed, clinical geriatricians, scientists trained in the biology of ageing, and investigators with experience in early phase clinical trials and drug regulatory systems will need to join forces and work together to prove or disprove the effectiveness of senotherapy.

At this early stage, we are also unclear about the potential side effects of senolytic drugs or whether such observable changes at the cellular level are permanent. Only time will tell as larger-scale and more granular testing is carried out in a clinical setting on human patients.