Over at In Search of Enlightenment, you'll find some thoughts on what we can expect to see when the first longevity-enhancing drugs are introduced into the present (predatory, oppressive, and frankly insane) medical regulatory environment. These early longevity drugs will most likely be the results of work aimed at adjusting metabolism to slow down aging - calorie restriction mimetics of some sort, perhaps. They will probably have only a modest beneficial impact on human life span, something along the lines of that sought by the Longevity Dividend advocates.
The case is made that the early years of drugs to slow aging will look something like the progression of statins. Bear in mind while reading that that the FDA does not consider aging to be a disease, and will therefore not approve any treatment for aging. Thus any potential longevity therapy is sidelined into development for one specific age-related disease very early on in its life, trials would focus on that narrow use only, and the therapy would only be authorized for that narrow use at the outset:
Back in 2008 the results of the JUPITER trial [for a statin] were published, and they showed that statins could reduce the incidence of major cardiovascular events in people with normal cholesterol levels. The FDA is considering permitting as many as 6 million people whose cholesterol levels fall within a normal range to take statins.
I find the case of statins interesting to follow for I believe it foreshadows the challenges that await the first anti-aging drug that will come to market in the not-too-distant future ... Such a drug will first be prescribed only for patients suffering a particular disease, like diabetes. But if this drug not only has a therapeutic benefit, but also delays the other diseases of aging with little or no side effects, then the door would be open to prescribing everyone take it.
If people are willing to tolerate a higher level of adverse side-effects from a drug that reduces cardiovascular risk than they are for cancer risk, I wonder what the attitude would be for a drug that reduced the risk of cancer, cardiovascular disease, AD, arthritis, disability and all the other afflictions of aging?
Hopefully development will proceed more rapidly in those parts of the world where it doesn't require a decade and countless millions of wasted dollars for the entrenched bureaucracy to unlock even the smallest of the shackles that bind research and commercial application of medical science.
Ultimately, however, I view the ongoing development of drugs to slow aging as a sideshow. Attempts to merely slow aging through manipulation of metabolism are inherently challenging by their very nature, even absent the oppressive regulatory environment. It is expensive to understand metabolism, and doubly expensive to alter it in any safe way. Even if real advances are made, drugs to slow aging will do little for people who are already old. If there is to be rapid progress towards enhanced longevity in our lifetimes, it must come from efforts like the Strategies for Engineered Negligible Senescence, where no attempt is made to alter metabolism, but researchers instead focus on the tools needed to reverse aging through the repair of biochemical and cellular damage. Ways to repair the damage and reverse the changes that occur in our cells with aging could bring great benefits to the aged, and once developed could be repeated over and again to keep damage at a minimal level across the years.
It is very clear to me that attempts to slow aging by altering human metabolism represent the wrong path for longevity science. These efforts will produce expensive, poor therapies that will do little for the old, and will take a long time to fully develop.