Validated treatments and therapeutics prospectives regarding pharmacological products for sarcopenia

Abstract

Loss of physical function in older adults may be, at least in part, explained by sarcopenia, a phenomenon characterized by a reduction in number and size of muscle fibres and by increase in interstitial fat and connective tissue. Lifestyle intervention (i.e. physical activity and nutrition) have shown to impact on sarcopenia. However, several drugs were suggested, with various levels of scientific evidence, to have an impact on muscle outcomes. In this study we reviewed the effect of six classes of drugs on sarcopenia and muscular outcomes in older adults. We decided to focus our review on two commonly drugs which have recently showed promising effects on muscular outcomes in older adults (ACE inhibitors and statins) and on four drugs whose effect on skeletal muscle was already largely studied (creatine, Growth Hormone, testosterone, estrogens and tibolone).

Effect of Angiotensin-Converting Enzyme Inhibitors on Physical Function in Elderly Subjects: A Systematic Review and Meta-Analysis

“…Many studies have shown that ACEIs have favorable effect on physical function. The mechanisms for effects of ACEIs on skeletal muscle may be concluded as muscle fiber type effect which determines a shift of the myosin-heavy chains of leg skeletal muscle from type II toward type I, Anti-inflammatory effect, nutritional effect, effects on angiogenesis and metabolic effect [54]. Our result showed that ACEIs could not improve gait speed and grip strength significantly, indicating that ACEIs could not improve physical function in elderly, which was inconsistent with the results from animal experiments [55][56][57][58].…”

Sarcopenia in older people

“…86 Examples are angiotensin-converting enzyme (ACE) inhibitors, statins, testosterone, growth hormones and oestrogen. 115,116 Despite some early promising results, however, it is currently difficult to recommend these pharmacological agents as part of a routine clinical treatment. Studies to date have not only been small in size, but have at times provided conflicting results.…”

Nutritional aspects of the cancer/aging interface

“…116 Some authors have shown that growth hormone and testosterone are able to increase muscle mass and in some cases strength in older persons [117][118][119][120][121][122] but clinicians should be cautious with such treatments because of the adverse effects and because the benefit tends to disappear when these agents are withhold.…”