Prevention

5.3.2 Senolytic drugs

Senolytic drugs are an emerging class of therapies developed to selectively target and clear senescent cells— aged, non-dividing cells that accumulate in the body over time, contributing to the aging process and a variety of chronic diseases. Notable examples of senolytic agents studied in animals and humans include rapamycin (an immunosuppressant drug) dasatinib (a cancer drug), quercetin (a plant flavonoid), and fisetin (another dietary flavonoid). Certain pharmaceutical agents are also being explored for their capacity to influence ageing processes, for example Metformin.

Metformin: primarily indicated for type 2 diabetes, has been associated with lower incidence rates of age-related diseases and all-cause mortality in large epidemiological cohorts. For example, Bannister et al., (2014) found that individuals with diabetes treated with metformin had a 15% lower adjusted risk of all-cause mortality compared to matched non-diabetic controls. Nonetheless, metformin’s effect size in healthy, non-diabetic populations is anticipated to be substantially smaller. Barzilai et al. (2016) estimate that, if metformin’s benefits in glucose regulation and cellular stress are translatable, median lifespan extension could range from several months up to 1–2 years, an order of magnitude less than the up to 9–24 years associated with sustained healthy lifestyle behaviours like those documented in the UK Biobank and Veterans Studies (Luo et al., 2022; Zhao et al., 2023).

Rapamycin: While human data are still emerging, rapamycin has been used off-label by some clinicians and individuals seeking anti-ageing benefits, largely inspired by extended median and maximal lifespan in mice (Harrison et al., 2009) and dogs (The Dog Aging Project, 2025). In humans, only small-scale trials and anecdotal reports are available suggesting potential for enhancing immune function in ageing. However, widespread use in humans is limited by concerns regarding side effects and the need for further clinical research to establish optimal dosing, safety, and efficacy for anti-ageing purposes.

Dasatinib and quercetin (D+Q): have been shown to significantly improve physical function and extend lifespan by up to 30% in one study on aged mice (Xu et al., 2018). Translation to humans remains at early stage with a pilot study on patients with idiopathic pulmonary fibrosis showing that D+Q was well-tolerated and resulted in some functional improvements. (Justice et al., 2019). There are no human data on lifespan or long-term health.

Other senolytics: under investigation include navitoclax (ABT-263), a BCL-2 family inhibitor originally developed for cancer, and the naturally occurring compound fisetin. While animal research is promising, robust data in humans regarding whether these agents can meaningfully extend healthspan or lifespan are not yet available. The scientific community remains cautiously optimistic, noting the need for larger and longer-term human clinical trials to determine efficacy and safety.