Cesari M, Fielding R, Bénichou O, Bernabei R, Bhasin S, Guralnik J M, Jette A, Landi F, Pahor M, Rodriguez-Manas L, Rolland Y, Roubenoff R, Sinclair A J, Studenski S, Travison T, Vellas B
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France ; INSERM UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France.
Jean Mayer USDA, Human Nutrition Research Center, Boston, MA, USA.
J Frailty Aging. 2015;4(3):114-120. doi: 10.14283/jfa.2015.64.
Sarcopenia and frailty often co-exist and both have physical function impairment as a core component. Yet despite the urgency of the problem, the development of pharmaceutical therapies for sarcopenia and frailty has lagged, in part because of the lack of consensus definitions for the two conditions. A task force of clinical and basic researchers, leaders from the pharmaceutical and nutritional industries, and representatives from non-profit organizations was established in 2012 with the aim of addressing specific issues affecting research and clinical activities on frailty and sarcopenia. The task force came together on April 22, 2015 in Boston, Massachusetts, prior to the International Conference on Frailty and Sarcopenia Research (ICFSR). The theme of this meeting was to discuss challenges related to drugs designed to target the biology of frailty and sarcopenia as well as more general questions about designing efficient drug trials for these conditions. The present article reports the results of the task force's deliberations based on available evidence and preliminary results of ongoing activities. Overall, the lack of a consensus definition for sarcopenia and frailty was felt as still present and severely limiting advancements in the field. However, agreement appears to be emerging that low mass alone provides insufficient clinical relevance if not combined with muscle weakness and/or functional impairment. In the next future, it will be important to build consensus on clinically meaningful functional outcomes and test/validate them in long-term observational studies.
肌肉减少症和衰弱症常常同时存在,且二者均以身体功能受损为核心特征。然而,尽管这一问题亟待解决,但针对肌肉减少症和衰弱症的药物治疗进展滞后,部分原因在于对这两种病症缺乏共识性定义。2012年成立了一个由临床和基础研究人员、制药与营养行业领袖以及非营利组织代表组成的特别工作组,旨在解决影响衰弱症和肌肉减少症研究及临床活动的具体问题。该特别工作组于2015年4月22日在马萨诸塞州波士顿召开会议,此次会议在国际衰弱症和肌肉减少症研究会议(ICFSR)之前举行。本次会议的主题是讨论与旨在针对衰弱症和肌肉减少症生物学特性的药物相关的挑战,以及关于为这些病症设计有效药物试验的更一般性问题。本文根据现有证据和正在进行活动的初步结果报告了特别工作组的审议结果。总体而言,人们认为肌肉减少症和衰弱症缺乏共识性定义的情况仍然存在,且严重限制了该领域的进展。然而,似乎正在形成的共识是,如果不与肌肉无力和/或功能受损相结合,仅低体重并不能提供足够的临床相关性。在未来,就具有临床意义的功能结局达成共识并在长期观察性研究中对其进行测试/验证将非常重要。