Dr Nir Barzilai predicts that rapamycin could decrease severity of coronavirus in the elderly by 50%.
Longevity.Technology: When it comes to the world of Longevity and anti-aging research, Albert Einstein College of Medicine, Professor of Medicine and Genetics Dr Nir Barzilai needs no introduction. One of the speakers on Monday 27th April at the Longevity2020 online conference (remember, all presentation content is free, so do please joins us) his planned TAME trial that seeks to build a template for trials of anti-aging therapies has been the subject of much attention.
It’s perhaps no surprise that the COVID-19 pandemic, which is having a profound effect on almost every aspect of global life has also impacted the start of the trial.
“Everybody is ready to go – we’re getting the IND and we have started the organisation of TAME,” says Barzilai. “But the recruiting of patients has to be considered not only as far as money goes, but also considering this epidemic. When is going to be the right time to start it? I don’t know the answer to that. I hope sooner rather than later. We still want to do it in 2020, but this is a setback for everyone and for us too.”
Barzilai feels that there are lessons to be learned from COVID-19, particularly as it disproportionately affects the older population.
“Aging has a biology and this biology can be modified,” he says, pointing out that existing drugs such as metformin and rapamycin are already in human use and could be used to help vulnerable age groups become more resilient to things like coronavirus.
“We have evidence that we can target aging and we have evidence that targeting aging also would have been relevant to the coronavirus and it’s very frustrating that we cannot get it through the channels now.”
“This just underlines it because the decrease in immunology and increasing inflammation are two of the hallmarks of aging,” says Barzilai. “And we know we can do something about it. And we were caught, not on the way from hope to promise, but on the way from promise to realising it.”
Geroscientists like Barzilai have long hypothesized that by targeting the biology of aging all diseases of aging can be delayed.
“We have evidence that we can target aging and we have evidence that targeting aging also would have been relevant to the coronavirus and it’s very frustrating that we cannot get it through the channels now,” he says. “I predict that something like rapamycin will decrease the severity of the disease in elderly by 50%. In other words, their time spent in hospital will decrease by at least five days. So it wouldn’t be a disaster – it would be exactly like the flu.”
Barzilai points out that metformin and rapamycin are already well understood, with established safety profiles, but that also target the biology of aging, immune mechanisms and resiliency.
“We must start discussing pragmatic approaches to rapidly implement the testing of such drugs in the face of the COVID-19 pandemic and an aging global population,” says Barzilai. “Time is of the essence since we can practically start targeting aging with such tools and prevent and modulate the disease and its personal and economical burdens.”
“We must start discussing pragmatic approaches to rapidly implement the testing of such drugs in the face of the COVID-19 pandemic and an aging global population.”
In fact, COVID-19 has given Barzilai some new thoughts for his forthcoming TAME trial.
“We are thinking to launch it with the first 50 volunteers also tested for their immunology,” he says. “In other words, to do a flu vaccine and see how they react to the flu vaccine both with and without metformin.”
The reason for this new thinking is not about the flu necessarily but looking ahead to when a coronavirus vaccine is going to be ready. Barzilai points out that vaccines are not as effective in the elderly population.
“Either you need more vaccine, or you need to make the elderly a little bit younger for the vaccine to work,” he says. “So it’s not only going to be relevant now – it’s going to be relevant for the next epidemic.”
In some ways, Barzilai feels lucky, because if we’ve been already recruiting all the patients now, we would have been in such trouble because we stopped all clinical studies.
“We would have been scrambling, but on the other hand, those who were on Metformin probably would have been protected and got less coronavirus,” he says. “But we don’t know – that’s what we will test.”