Cited by 127Telomeres, Telomerase, and SenescenceBone health and osteoporosis researchBone Metabolism and Diseases

Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial

Open access
Farr, Joshua N., Atkinson, Elizabeth J., Achenbach, Sara J., Volkman, Tammie L., Tweed, Amanda J., Vos, Stephanie J., Ruan, Ming, Sfeir, Jad +10 more·2024·Nature Medicine

Abstract

Preclinical evidence demonstrates that senescent cells accumulate with aging and that senolytics delay multiple age-related morbidities, including bone loss. Thus, we conducted a phase 2 randomized controlled trial of intermittent administration of the senolytic combination dasatinib plus quercetin (D + Q) in postmenopausal women (n = 60 participants). The primary endpoint, percentage changes at 20 weeks in the bone resorption marker C-terminal telopeptide of type 1 collagen (CTx), did not differ between groups (median (interquartile range), D + Q -4.1% (-13.2, 2.6), control -7.7% (-20.1, 14.3); P = 0.611). The secondary endpoint, percentage changes in the bone formation marker procollagen type 1 N-terminal propeptide (P1NP), increased significantly (relative to control) in the D + Q group at both 2 weeks (+16%, P = 0.020) and 4 weeks (+16%, P = 0.024), but was not different from control at 20 weeks (-9%, P = 0.149). No serious adverse events were observed. In exploratory analyses, the skeletal response to D + Q was driven principally by women with a high senescent cell burden (highest tertile for T cell p16 (also known as CDKN2A) mRNA levels) in which D + Q concomitantly increased P1NP (+34%, P = 0.035) and reduced CTx (-11%, P = 0.049) at 2 weeks, and increased radius bone mineral density (+2.7%, P = 0.004) at 20 weeks. Thus, intermittent D + Q treatment did not reduce bone resorption in the overall group of postmenopausal women. However, our exploratory analyses indicate that further studies are needed testing the hypothesis that the underlying senescent cell burden may dictate the clinical response to senolytics. ClinicalTrials.gov identifier: NCT04313634 .

Integrity signals

Registry

Crossref · 10.1038/s41591-024-03096-2

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

  • Finding

    In exploratory analyses, the highest tertile of T cell p16 mRNA levels showed increases in P1NP and reductions in CTx after D + Q treatment.

    “serum P1NP increased at 2 weeks in the T3 D + Q group (relative to control, +34%, P = 0.035)”
    Quote in the paperNot yet classified
  • Finding

    The authors conclude that the p16_variant 5 assay more effectively identified individuals likely to have a favorable skeletal response to D + Q than the p16_variant 1 + 5 assay.

    “the p16_variant 5 assay appeared to more effectively identify individuals likely to have a favorable skeletal response to D + Q compared with the p16_variant 1 + 5 assay.”
    Quote in the paperNot yet classified
  • Finding

    The trial found that D + Q increased the bone formation marker P1NP at 2 and 4 weeks, but not at 20 weeks, in the overall group.

    “the secondary endpoint, percentage changes in the bone formation marker procollagen type 1 N-terminal propeptide (P1NP), increased significantly (relative to control) in the D + Q group at both 2 weeks (+16%, P = 0.020) and 4 weeks (+16%, P = 0.024), but was not different from control at 20 weeks”
    Quote in the paperNot yet classified
  • Finding

    Baseline SASP factors were generally higher in the T3 group than in the T1/T2 group.

    “baseline SASP factors were generally higher in the T3 group versus the T1/T2 group”
    Quote in the paperNot yet classified
  • Finding

    In the T3 group, changes in SASP factors did not differ between the control and D + Q groups.

    “changes in SASP factors did not differ between the control and D + Q groups”
    Quote in the paperNot yet classified

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Intraocular study counted as systemic administration

    Minor

    The discussion includes the diabetic macular edema study among prior studies of systemic senolytic administration, but the paper earlier describes that treatment as a single intraocular injection.

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Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

  • Cites a retracted work: 10.1016/j.fitote.2015.09.018

    Info

    The cited work was retracted on 2024-12-28 (notice 10.1016/j.fitote.2024.106320), not before this paper was published (2024-07-02).

    Cited work 10.1016/j.fitote.2015.09.018 · retracted 2024-12-28 · notice 10.1016/j.fitote.2024.106320 · this paper published 2024-07-02

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Authors
Farr, J. N., Atkinson, E. J., Achenbach, S. J., Volkman, T. L., Tweed, A. J., Vos, S. J., Ruan, M., Sfeir, J., Drake, M. T., Saul, D., Doolittle, M. L., Bancos, I., Yu, K., Tchkonia, T., LeBrasseur, N. K., Kirkland, J. L., Monroe, D. G., & Khosla, S.
Affiliations
Mayo Clinic (US)
Corresponding author
  • Farr, Joshua N.
  • Khosla, Sundeep
Venue
Nature Medicine
Published
2024-07-02
Volume
30
Issue
9
Pages
2605-2612
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W4400248879
Cited by
127
References
39
Citations by year
2026: 67 · 2025: 55 · 2024: 5
FWCI
35.85
Type
journal article
Language
en
Open access
Locations
  • Nature Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • Digital Commons-TMC (Texas Medical Center) (submittedVersion)
Funders
  • U.S. Department of Health & Human Services | NIH | National Institute on Aging (R21 AG065868, R01 AG076515, R01 AG055529, R37 AG13925, R33 AG61456, P01 AG062413, R01 AG 062413)
  • U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK128552)
Topics
  • Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords
senolytics, intermittent dosing, dasatinib, quercetin, bone metabolism, postmenopausal women, bone loss, bone resorption, bone formation, C-terminal telopeptide of type I collagen, P1NP, CDKN2A, bone mineral density, aging
MeSH terms
Dasatinib, Senotherapeutics, Aged, Bone and Bones, Bone Resorption, Female, Humans, Middle Aged, Peptide Fragments, Peptides, Procollagen, Quercetin, Biomarkers, Bone Density, Cellular Senescence, Postmenopause, Cyclin-Dependent Kinase Inhibitor p16, Collagen Type I

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