Citi has produced another of its Disruptive Innovations publications, which takes a look at what it considers to be the top ten disruptive technologies. It is a sign of the changing times that anti-aging medicines are number 2 in its list.
1. All-Solid-State Batteries
2. Anti-Aging Medicines
3. Autonomous Vehicle Networks
4. Big Data & Healthcare
5. Dynamic Spectrum Access
7. 5G Technology
8. Floating Offshore Wind Farms
9. Real Estate Market Disruptors
10. Smart Voice-Activated Assistants
What was considered fringe science a decade ago is now rapidly becoming a mainstream industry. Our understanding of aging has advanced quickly in the last 10 years, and the tools and innovations seem to come more quickly with each passing year. A variety of therapies that target different aging processes are in development, and some are at fairly advanced stages; if you are interested in their progress, check out the Rejuvenation Roadmap.
Advancing Health by Turning Back Time
The legend of the restorative powers of the Fountain of Youth has fascinated human civilization throughout the generations, dating all the way back to the Greeks (e.g., Herodotus). Other hypothetical conduits for a return to a state of youthfulness (e.g. the Philosopher’s Stone) have featured prominently throughout human civilization as alluring, but equally elusive. Fast forward to 2018, and very recent cutting-edge scientific breakthroughs may, at long last, fundamentally explain why we age. This rapid scientific progress could spawn FDA-approved therapeutics potentially in the next decade, with the primary goal of keeping us younger and alive for longer.
Today, the anti-aging market, while huge (~$200 billion globally), is largely restricted to non-therapeutics (cosmetic products and procedures). At the same time, U.S. health spending, which increases significantly with age in concordance with age-related diseases (see Figure 8), is expected to exceed ~20% of U.S. gross domestic product (GDP) by 2025. Thus, with scientific breakthroughs emerging this decade on the cellular origins of why the tissues in our body’s age, novel anti-aging medicines may become one of the next big disruptions in the healthcare market.
Senolytics are the main focus here, which is logical given that, of all the therapies being developed to combat aging, they are the farthest along in the pipeline. These analysts suggest that we could see senolytics arrive by 2023; while these drugs are only part of the full suite of therapies required to bring aging under medical control, it is likely that we will see senolytics and, perhaps, a few other therapies arrive at that time.
First Senolytic Therapy Could Be Approved by 2023
The first senolytic therapy in clinical trials is a compound by Unity, UBX0101, which is a small-molecule drug that functions by inducing apoptosis (i.e., programmed cell death), specifically in senescent cells. The company is first testing UBX0101 locally in patients with moderate osteoarthritis of the knee, which is a substantially large market (~17 million patients). Initial proof-of-concept data from the Phase 1 trial are expected in the first quarter of 2019. If successful in later clinical development through Phase 3, UBX0101 could become commercially available by 2023.
While speculative given the novelty of the senolytic therapeutic strategy, a successful therapeutic that could resolve osteoarthritic knees and return knee tissue to a more youthful state could have a negative impact on the knee-replacement surgery market (currently projected to grow to >3 million knee replacements per year by 2030). Because other senolytics are being developed for multiple
ophthalmologic (wet AMD, glaucoma, diabetic retinopathy) and pulmonary (COPD, idiopathic pulmonary disease) indications, within the next ~10–20 years patients with a range of age-related diseases may experience a decreased need for therapies now considered standard of care.
UNITY, Siwa, and Oisin are all mentioned in the report. and it is worth having a read, as the section about aging is fairly large and detailed and takes a look at past and present attempts to combat age-related diseases by targeting the aging processes directly.
It is beyond question that progress and interest in the field is growing quickly, and with some therapies now entering human trials, we could be close to a societal tipping point at which more people start to take notice of the potential of new medical approaches. There is a long way to go before we can end age-related diseases, but the tide has turned.