Just how bad are we at treating age-related diseases?

Summary

This post was last updated in September 2024. I can’t promise this will be up-to-date when you come across it.Whether you believe in preventing damage (the core aim of the aging field - though that's not the focus of this post) or treating damage as it arises, our current best efforts in both treatment and mechanism selection haven’t yielded promising results. None of the approved drugs for age-related diseases reverse any damage. They don't even halt disease progression. The primary endpoints mainly assess whether the treatment causes a slightly slower rate of decline than would occur otherwise. In some cases, approved drugs show no objective functional benefit at all. So how did we get here?Geographic atrophy (GA)GA is a gradual loss of central vision due to the breakdown of the retinal cells responsible for detailed sight – retinal pigment epithelium and photoreceptors. TLDR:2 approved drugs, Syfovre (pegcetacoplan) and Izervay (ACP) - both approved in 2023Neither drug halts disease progression. Atrophy progresses at a slightly slower rate (~19% less lesions after 2 years of monthly Syfovre eye injections)Importantly, recent GA trials stopped relying on eyesight (measured through visual acuity score BCVA) as the primary endpoint. After multiple drugs failed to improve vision, the field switched to “lesion growth” as a trial readoutAs a result, both Syfovre (pegcetacoplan) and Izervay (ACP) treated patients had a decline in vision similar to untreated patients - that is, while results of the trial were statistically significant, you or your family wouldn’t be able to tell as to whether you took the drugIdiopathic Pulmonary Fibrosis (IPF)IPF is a disease where the lungs become scarred over time for no clear reason. This scarring makes it harder for your lungs to take in oxygen, so people with IPF often feel short of breath or have a dry cough. TLDR:2 approved drugs, nintedanib, pirfenidone - both approved in 2014The primary endpoint for the trial is forced vital ca...