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 In September life-science company Calico, which was set up by Google
last year to investigate the aging process, joined with U.S.
drugmaker AbbVie in committing an initial $250 million apiece to
developing cures for age-related diseases.
Away from the limelight, however, Switzerland's Novartis and
Denmark's Novo Nordisk are already testing new roles for existing
drugs, which could keep people alive for longer, as they look to
cater to the ever larger numbers living into their 80s and beyond.
"Everybody now is talking about the aging population and how to have
a healthy old age," said Mads Krogsgaard Thomsen, Chief Science
Officer at Novo Nordisk.
By 2020 people aged 60 and older will outnumber children younger
than five for the first time in history, according to a paper
published in the Lancet medical journal on Thursday.
But with greater age comes a bigger burden of disease.
At least 300 million people will suffer from diabetes by 2025, the
World Health Organization estimates, while the global number of
dementia sufferers is expected to triple to 135 million by 2050.
The goal is not to create some "elixir of life" pill to help people
live ever longer, but rather to maximize healthy lifespan and reduce
the period of end-of-life sickness and dependency.
Alex Zhavoronkov, chief executive of Baltimore-based biotech company
Insilico Medicine, believes shifting healthcare spending from
treatment to prevention will be central to this.
"Instead of trying to keep a person alive for another three to six
months and essentially bankrupting healthcare systems, it might make
sense to introduce drugs that prevent the onset of age-related
diseases and aging itself," he said.
IMMUNE SYSTEM BOOSTER
Research into anti-ageing drugs has historically received little
attention from Big Pharma, given the difficulties of running
clinical trials to prove such an effect.
Moreover, companies have been deterred by regulators in the United
States and Europe who will only approve medicines for specific
illnesses and not for something as broad as aging, which is not in
itself defined as a treatable disease.
Despite these obstacles, Novartis has completed a successful pilot
trial examining its cancer drug everolimus as a potential treatment
to reverse immunosenescence, or the gradual deterioration of the
immune system that occurs with age and is a major cause of disease
and death.
Encouraged by studies showing that the closely related drug
rapamycin extended the lifespan of worms, flies and mice, Novartis
looked for ways to assess whether everolimus could have a similar
effect in humans.
The hurdles were high. Aging is a gradual, decades-long process
making it impractical to assess directly in clinical trials.
"For aging you have to pick a target system that can be investigated
in months or years, not decades," said Novartis's head of research
Mark Fishman.
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The company's work-around is to focus on immunosenescence. It gave
218 people aged over 65 a six-week course of everolimus followed by
a regular flu vaccine after two weeks.
Results showed that taking the drug improved the immune system
response by more than 20 percent compared to placebo, potentially
opening the door to use it as a treatment to increase the efficacy
of vaccines and help stave off the infections associated with old
age.
While Fishman stresses the research is still early-stage, Novartis's
work highlights the growing interest in aging as a biological
process that can be manipulated, treated and delayed.
OLD DRUGS, NEW PURPOSE
Given the regulatory barriers, experts believe re-purposing existing
treatments in new indications will likely be the fastest way to get
drugs with an anti-ageing benefit to market, since these medicines
have already been proven safe.
A study published in the journal Neuropharmacology this week found
lixisenatide, a drug sold as Lyxumia by Sanofi to treat type 2
diabetes, could slow nerve cell damage in mice with some of the
hallmarks of Alzheimer's disease.
Other diabetes drugs may have a similar effect.
Imperial College London is currently recruiting around 200 patients
with mild Alzheimer's for a study with Novo Nordisk's diabetes drug
liraglutide, or Victoza.
"It would be fantastic if we were able to take a safe and simple
type 2 diabetes medicine and use that in Alzheimer's," said Novo's
Thomsen.
The results are due in two to three years and if there is a
significant benefit to cognition Novo Nordisk would consider
conducting a pivotal clinical trial, he added.
The Danish company, which is the world's biggest maker of insulin,
is also working with academics at the University of Oxford, the
Karolinska Institute and the University of Copenhagen on a new
project looking at healthy aging.
Its interest in the field has a scientific logic, since some of the
genes that researchers are now exploring as factors in healthy aging
have links to the body's insulin pathways.
(Additional reporting by Ben Hirschler in London; Editing by Greg
Mahlich)
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