H-SPAN summit panel proposes treating aging as a “metadisease” and assessing therapies across multiple outcomes

H-SPAN summit panel proposes treating aging as a “metadisease” and assessing therapies across multiple outcomes

At an H-SPAN panel on aging biology on September 9, anatomist Antonei Csoka proposed describing aging as a “metadisease,” a shared process linked to several age-related diseases. Panelists discussed how this framing could help clinical trials assess interventions targeting aging biology through a set of related outcomes.

>The July report on H-SPAN described the summit’s second day as devoted to clinical endpoints and FDA rules. The current panel raised a specific question for that agenda: if a therapy changes the shared process of aging, what exactly should a single clinical trial assess?

A trial needs to specify in advance what it aims to change and select an endpoint, a measurable treatment outcome. When a drug targets a single disease, that choice is usually straightforward. The panelists’ reasoning was that an intervention targeting processes linked to several age-related diseases would require a set of related measures.

Csoka describes aging as a “metadisease”: a biological process that gives rise to several age-related pathologies. Central to his model is cellular senescence, a state in which cells stop dividing and alter tissue function.

Csoka proposed using an International Classification of Diseases (ICD) code for aging as a metadisease. In his view, this would allow a single trial to assess several outcomes.

He linked this problem to the organization of scientific research and proposed establishing a federal institute of geroscience, the study of aging biology, alongside the National Institute on Aging. George Sutphin said that aging researchers often work within university programs focused on cancer, heart disease, or Alzheimer’s disease. Such an institute could bring their work together around the shared biological processes of aging.