Excellent review from NUS
Tsai SY. Lost in translation: challenges of current pharmacotherapy for sarcopenia. Trends in Molecular Medicine. Published online June 2024:S1471491424001382.
https://doi.org/10.1...med.2024.05.016
A healthy lifespan relies on independent living, in which active skeletal muscle
is a critical element. The cost of not recognizing and acting earlier on unhealthy
or aging muscle could be detrimental, since muscular weakness is inversely
associated with all-cause mortality. Sarcopenia is characterized by a decline
in skeletal muscle mass and strength and is associated with aging. Exercise
is the only effective therapy to delay sarcopenia development and improve
muscle health in older adults. Although numerous interventions have been proposed
to reduce sarcopenia, none has yet succeeded in clinical trials. This
review evaluates the biological gap between recent clinical trials targeting sarcopenia
and the preclinical studies on which they are based, and suggests an
alternative approach to bridge the discrepancy.
For having tried and still considering testosterone replacement, I found this part interesting:
“Numerous studies have shown that testosterone application weekly or daily for 1–5 months results in elevated lean muscle mass and marginally increased leg strength (Table S3 in the supplemental material online). However, there was no physical performance improvement by testosterone replacement in these clinical trials. Moreover, a dose-dependent increase in testosterone-related adverse events – including leg edema, urinary retention, and prostate cancer – are reported in older males, which are not found in young males [22]. The Testosterone in Older Men with Mobility Limitations trial was terminated early due to a higher number of cardiovascular-related adverse events in the testosterone-treated group [23]. Thus, the potential adverse impact on cardiovascular health must be considered when determining the clinical application of testosterone for the purpose of promoting muscle anabolism. The latest research on testosterone has resulted in a lower recommended dose and a modified route of administration in trials [24,25]. Other than the increases in lean mass, both the placebo and testosterone groups experienced a similar level of decline in muscle strength and performance. While the lower daily dosage of testosterone treatment did increase serum testosterone levels twofold to approximately a normal range, it did not sufficiently counteract muscle aging.”
