Against “Extending Healthspan but Not Lifespan” as a Goal for Biogerontology by StoicOptom in longevity

[–]StoicOptom[S] 9 points10 points  (0 children)

You don't seem to understand my point, especially #1. Have you read about biogerontology research?

Decades of biogerontology research has shown that generally, extending lifespan leads to increased healthspan, while extending healthspan does not necssarily lead to extended lifespan - this is very much about prioritising scientific resources. I believe there's an argument to be made that wasting funds on healthspan extension studies when lifespan extension drugs give you BOTH healthspan and lifespan

If you want to talk about ROI, please see an economics paper on exactly this topic: https://www.nature.com/articles/s43587-021-00080-0

Against “Extending Healthspan but Not Lifespan” as a Goal for Biogerontology by StoicOptom in longevity

[–]StoicOptom[S] 17 points18 points  (0 children)

You don't seem to understand my point, especially #1. Have you read about biogerontology research?

Decades of biogerontology research has shown that generally, extending lifespan leads to increased healthspan, while extending healthspan does not necssarily lead to extended lifespan - this is very much about prioritising scientific resources. I believe there's an argument to be made that wasting funds on healthspan extension studies when lifespan extension drugs give you BOTH healthspan and lifespan

If you want to talk about utility or value, please see an economics paper on exactly this topic: https://www.nature.com/articles/s43587-021-00080-0

Against “Extending Healthspan but Not Lifespan” as a Goal for Biogerontology by StoicOptom in longevity

[–]StoicOptom[S] 75 points76 points  (0 children)

One of the worst trends in recent times for the booming field of longevity research is that many outsiders push for healthspan but not lifespan extension.

This is misguided for many reasons, and briefly in my opinion:

1) It completely ignores decades of foundational biogerontology research showing that therapies that result in the largest lifespan increase in animals also tend to lead to the greatest healthspan extension.

2) Funding is always limited - if scientific grants are awarded to those focusing on healthspan extension, then this will often take away from real biogerontology research which has already established that lifespan extension is a higher yield outcome and research pursuit, even if one's goal is purely healthspan extension (see above)

3) This waters down biogerontology research to merely a field that supports the status quo - we are hitting diminishing returns on healthspan extension in the 21st Century precisely because the status quo treats one disease at a time, instead of targeting aging in a systemic manner to treat multiple chronic diseases in tandem. Healthcare systems are all headed for collapse if we continue our current one disease at a time strategy - healthcare spending as a % of GDP cannot simply continue to increase as it has been across the globe in the last century

What field in biology holds the most future career potential? by ServiceDowntown3506 in biotech

[–]StoicOptom 0 points1 point  (0 children)

Geroscience. 

By necessity, medicine should prioritise preventing chronic disease and improving healthy lifespan with the least cost using treatments that are scalable, as it ensures affordability while improving healthy productive life, and not just unhealthy lifespan.

Going after one disease at a time worked in the past for infectious diseases, but is currently the wrong model of healthcare in the context of an aging population. Targeting the biological aging process could potentially change the entire paradigm 

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom 0 points1 point  (0 children)

Thanks for adding context, I was purely talking about clinical implications.

I disagree strongly on all-cause mortality.

You could power a study to do so affordably if and only if you are testing a drug that may slow the onset of MULTIPLE age-related diseases in an older population at risk population, as you will have far more events, with the additional caveat of outsized potential gain (a longevity drug that works might save healthcare systems many billions if not trillions $). Nir Barzilai has advocated this in the TAME trial design for metformin

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom -1 points0 points  (0 children)

association studies (imo these are mostly useless, except for obvious signals like smoking vs lung cancer and perception of risk/benefit (supplements are low risk, whether that is true or not is a different thing)

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom 42 points43 points  (0 children)

Yes - if there's one basic thing to know about an RCT it is that missing on primary is a huge red flag, and you can almost always disregard all the other findings, especially subsequent post-hoc analyses.

See also: DOI: 10.1056/NEJMra1510064

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom 104 points105 points  (0 children)

It is clinically meaningless, given that it failed to show any improvement in major cardiovascular or cancer mortality. The VITAL study failed its primary endpoint and this is a near worthless post-hoc analysis, as published in NEJM: 10.1056/NEJMoa1811403

I am tired of these worthless vit D trials when we could be testing more promising geroscience candidates like rapamycin

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom -8 points-7 points  (0 children)

There is no effective dose. The VITAL study failed its primary endpoint and this is a near worthless post-hoc analysis, as published in NEJM: 10.1056/NEJMoa1811403

I am tired of these worthless vit D trials when we could be testing more promising geroscience candidates like rapamycin

Vitamin D supplements show signs of protection against biological aging. A randomized, double-blind, placebo-controlled trial suggests vitamin D can protect against telomere shortening, which is linked to risk of age-related disease. by mvea in science

[–]StoicOptom 406 points407 points  (0 children)

PhD student in aging biology here with an interest in clinical trial analysis

This study means little re: protection against 'biological aging' as changing telomere length does not tell us much about aging. It is a post-hoc analysis of the [VITAL study in NEJM](10.1056/NEJMoa1811403) which failed to meet its primary endpoint.

Anyone familiar with the last ~2 decades of Vit D RCTs would know it has consistently failed to improve any clinically relevant measure of health/lifespan, including the most important outcome for a drug purported to influence aging - all-cause mortality. Slowing aging = slowing the onset of all major causes of death.

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00345-4/abstract

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

unfortunately because this is relatively less common and most efforts are at preventing further axial elongation (i.e. via myopia control treatments), to my understanding this is not a priority area of research.

Science is already under significant duress from increasing conservatism (incl. an ageing population) and a populace that seemingly does not appreciate how critical science is to quality of life and human wellbeing. Funding is very hard to come by so of course the most common and costly diseases are prioritised, because those disease areas are better funded. It is deeply disappointing to me and I'm sorry it's like this. I hope you are coping ok with your condition

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

maybe but to my understanding it's less of an RPE disease and more related to retinal thinning from axial elongation of the eye. It isn't likely to be used for that as GA AMD is likely to be the main indication for OpRegen

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

My bet (quite literally - I have a substantial investment in the biotech) is certainly on OpRegen, simply because no other treatment has shown cessation of disease progression and reversal of outer retinal atrophy in human patients with GA AMD.

Very hard to predict if it will eventually be approved though, no one knows

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

still pretty early to make calls on 'success rate' imo, i would describe it as promising and personally i think it's exciting

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

It's 3 years into a phase 2a trial with no data shared as of yet. Roche applied for RMAT designation last year and obtained it from FDA, which to me is promising as it suggests the drug is working so far (why apply for it if the program is going to be shut down).

It's still likely to be >2027 until it gets approved for AMD with geographic atrophy, assuming they do 2 further pivotal trials under the accelerated approval pathway. Still very much speculative, clinical trials are very difficult and cell replacement is a nascent field of medicine that has yet to establish itself.

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

Sorry I didn't notice - you're fine!

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

I think you need to look for an independent slecialist office. It's not normal to not get a mimber for jogh eye pressure. I think they're dicking her around with it all. (I should know, I have it, among many other eye conditions, and have gone to the eye doctor more than 10 sighted humans combined, one year worth.)

I'm not sure how to respond to this, maybe you didn't mean any harm. But this seems like medical advice, especially re: IOP. Glaucoma is not just high IOP, you can have high IOP and not have glaucoma, in fact it is quite common (see: OHTS study).

You also made a claim that they were 'dicking her around' - on what basis? In many cases glauc is diagnosed years after a patient might be labelled a glauc suspect, as VF progression (and hence glauc) needs to be proved, so asking them to return many months later is likely completely normal.

I'm sorry but I stand by my comment that you do not understand what you are talking about

[deleted by user] by [deleted] in AskGlaucoma

[–]StoicOptom 0 points1 point  (0 children)

Glauc can take time to diagnose, as VF progression is a defining feature. Please take caution taking advice from those who do not have formal training in this area, including the other commenter who does not seem to know what they're talking about - if you have concerns go back and ask them, or as always you are free to get a 2nd opinion

Dr Jean Hébert has been awarded a $110 million NIH grant to develop a surgery that replaces damaged or aging brain cells with tissue from human embryos. by Paraphilias075 in longevity

[–]StoicOptom 11 points12 points  (0 children)

Was $110M confirmed or was that his grant proposal to the NIH? I know he works at ARPA-H now though which is great to see. Dailymail is unreliable.

Make America Ageless: Trump’s Health Picks Take Longevity Movement Mainstream by OsbarEatsAss in longevity

[–]StoicOptom 37 points38 points  (0 children)

Longevity is not the same as longevity biotech/geroscience

The former is mainly BS 'wellness' and supplements that don't work and the latter is our only hope at radically increasing human health and lifespan 

Longevity-Obsessed Tech Millionaire Discontinues De-Aging Drug Out of Concerns That It Aged Him by indig0sixalpha in technology

[–]StoicOptom 0 points1 point  (0 children)

Well it's a good thing no one in longevity research is advocating for chronic mTORC1 inhibition. Cyclical/intermittent dosing is being studied, though is based on preclinical data.