Gérontopôle de Toulouse, IHU HealthAge, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France; CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, Toulouse, France.
Université de Toulouse III Université Paul Sabatier, Toulouse, France; Restore, a geroscience and rejuvenation research center, UMR 1301-Inserm, 5070-CNRS EFS, France.
Metabolism. 2023 Dec;149:155597. doi: 10.1016/j.metabol.2023.155597. Epub 2023 Jun 20.
Sarcopenia, defined as the loss of muscle mass and function, is a widely prevalent and severe condition in older adults. Since 2016, it is recognized as a disease. Strength exercise training and nutritional support are the frontline treatment of sarcopenia, with no drug currently approved for this indication. However, new therapeutic options are emerging. In this review, we evidenced that only very few trials have focused on sarcopenia/sarcopenic patients. Most drug trials were performed in different clinical older populations (e.g., men with hypogonadism, post-menopausal women at risk for osteoporosis), and their efficacy were tested separately on the components of sarcopenia (muscle mass, muscle strength and physical performances). Results from trials testing the effects of Testosterone, Selective Androgen Receptor Modulators (SARMs), Estrogen, Dehydroepiandrosterone (DHEA), Insulin-like Growth Factor-1 (IGF-1), Growth Hormone (GH), GH Secretagogue (GHS), drug targeting Myostatin and Activin receptor pathway, Vitamin D, Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), or β-blockers, were compiled. Although some drugs have been effective in improving muscle mass and/or strength, this was not translated into clinically relevant improvements on physical performance. Finally, some promising molecules investigated in on-going clinical trials and in pre-clinical phase were summarized, including apelin and irisin.
肌肉减少症，定义为肌肉质量和功能的丧失，是老年人中广泛存在且严重的一种病症。自 2016 年以来，它被认为是一种疾病。力量训练和营养支持是肌肉减少症的一线治疗方法，目前没有批准用于该适应症的药物。然而，新的治疗选择正在出现。在这篇综述中，我们证明只有极少数试验集中在肌肉减少症/肌肉减少症患者身上。大多数药物试验是在不同的老年临床人群中进行的（例如，患有性腺功能减退的男性、有骨质疏松症风险的绝经后女性），并且它们的疗效分别在肌肉减少症的各个组成部分（肌肉质量、肌肉力量和身体表现）上进行了测试。测试睾酮、选择性雄激素受体调节剂 (SARMs)、雌激素、脱氢表雄酮 (DHEA)、胰岛素样生长因子-1 (IGF-1)、生长激素 (GH)、生长激素释放肽 (GHS)、肌肉减少症和激活素受体途径药物靶向、维生素 D、血管紧张素转换酶抑制剂 (ACEi) 和血管紧张素受体阻滞剂 (ARB) 或β-受体阻滞剂的效果的试验结果进行了编译。尽管一些药物在改善肌肉质量和/或力量方面有效，但这并没有转化为身体机能的临床相关改善。最后，总结了一些正在进行的临床试验和临床前阶段中研究的有前途的分子，包括 apelin 和 irisin。
