Metformin and the TAME Trial: Magic Pill or Monumental Tool?

Written and submitted by Nir Barzilai.

Nir currently serves as Director of the Institute for Aging Research at Albert Einstein College of Medicine, where he is also Director of the NIH’s Nathan Shock Center of Excellence in the Basic Biology of Aging and the Paul F. Glenn Center for the Biology of Human Aging Research. Dr. Barzilai is also the Deputy Scientific Director of the American Federation for Aging Research (AFAR). Nir spoke on the TEDMED stage in 2016, and you can watch his talk here.

Today, the possibility of living healthier and longer is not science fiction—it’s science.

Thanks to the more than three decades of research in the basic biology of aging, a range of promising drug interventions are ready to transform growing older from a period of sickness to a period of vitality.

These interventions build on the knowledge that the biological processes of aging are the major driver of major diseases that afflict so many of us we grow older.

If we targeted or delayed aging, we could delay or prevent age-related diseases.The most promising effort is a new study, the TAME (Targeting Aging with Metformin) Trial: this novel clinical trial will test whether the drug metformin—a widely used, affordable treatment for type 2 diabetes—can delay the onset of age-related diseases including cancer, diabetes, and heart disease.

Funds must be secured in order to take what we have learned from the lab to human trials, but let’s be clear: metformin is not a magic pill.

Rather, the TAME Trial is a tool that can monumentally improve our health as we grow older. The metformin clinical trial will serve as the tool or framework for the most important medical intervention in the modern era since antibiotics—a new category of drugs that add years of healthy life as we age.

For each of us individually, TAME will help decrease disease. If successful, TAME is expected to lead to the use of Metformin and the development of other drugs to target aging and help delay or prevent the onset of debilitating conditions or diseases.

Plus, we will be less at risk for financial fraud or exploitation, as cognitive skills necessary for essential functions such as managing medications and finances—such as memory, reasoning, perception, and language skills—will be less impaired.

For society at large, the development of drugs resulting from the TAME trial will increase health care savings. A recent economic analysis showed that slowing or modifying age-related diseases by just 20 percent would save more than $7 trillion in health care spending in the United States alone over the next half-century.

We call this the Longevity Dividend: if we increase years of health as we age, we actually can decrease the financial burden of related healthcare costs.

Moreover, the TAME Trial would cost 96% less than the cost to develop and win market approval for a single drug: $69 million vs. $2.4 billion, as estimated in a 2014 Tufts University Study.

By focusing on metformin first, as a paradigm of a drug targeting aging, the TAME trial has the potential to unleash the powerful research and development engine of the pharmaceutical
industry to generate next-generation drugs, individually or in combination, to prevent and delay multiple age-related diseases.

In turn, we can transform aging from a period of sickness to a time of extended vitality, and age-related diseases can be treated more effectively and cost effectively.

In essence, we can live longer and live well.

With one American turning 65 every eight seconds today, the TAME Trial is a small investment that can make huge impact by saving trillions of dollars while invigorating millions of lives.

In an era of rising health care costs and unpredictable health care coverage, delaying or targeting aging could be the most efficient method of achieving primary prevention available to us in this century.

The field is ready to translate basic biomedical research into clinical trials like TAME, yielding therapeutic interventions that will extend health while decreasing healthcare costs.

With a concentrated, coordinated effort across the public, private, and philanthropic sectors, together we can move aging research from the labs into our lives.

The TAME Trial is poised to be a monumental tool to transform how we age.