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Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial
Open accessAbstract
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 .
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“serum P1NP increased at 2 weeks in the T3 D + Q group (relative to control, +34%, P = 0.035)”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Results > Exploratory and post hoc analyses
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“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.”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Results > Exploratory and post hoc analyses
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In the paper
“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”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Abstract
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“baseline SASP factors were generally higher in the T3 group versus the T1/T2 group”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Results > Assessment of SASP factors
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“changes in SASP factors did not differ between the control and D + Q groups”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Results > Assessment of SASP factors
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“in humans, senolytics (or at least, D + Q with our monthly dosing regimen) may preferentially stimulate bone formation over inhibiting bone resorption”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Discussion
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In the paper
“radius BMD at 20 weeks, which increased by 2.7% in response to D + Q relative to control (P = 0.004) in the T3 group”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Results > Exploratory and post hoc analyses
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study represents the largest (n = 60) RCT of sustained intermittent administration of a senolytic regimen to generally healthy older women.”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Discussion
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“our findings support the hypothesis that the skeletal, and perhaps nonskeletal, response to a senolytic intervention depends on the existing senescent cell burden.”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Discussion
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“intermittent D + Q treatment did not reduce bone resorption in the overall group of postmenopausal women.”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Abstract
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In the citing paper
“a Phase 2 trial in postmenopausal women showed limited biomarker changes with subtle or no significant clinical improvements in bone mass37.”
From Emerging strategies in senotherapeutics: from broad-spectrum senolysis to precision reprogramming (2026) · cites this paper as [37]
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§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Discussion
“Previous studies of systemic administration of senolytics have not included a control group, recruited only a limited number of patients with diabetes-associated chronic kidney disease (n = 9)32, idiopathic pulmonary fibrosis (n = 14)33, dementia (n = 5)11 or diabetic macular edema (n = 8)12”
§ Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial > Abstract
“a single intraocular administration of another senolytic compound, the BCL-xL inhibitor UBX1325, was safe and improved visual acuity in five of eight patients with diabetic macular edema”
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In the paper
“D’Andrea, G. Quercetin: a flavonol with multifaceted therapeutic applications? Fitoterapia 106, 256–271 (2015).”
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
Citations
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1 retracted
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Self-citationNaturally occurring p16Ink4a-positive cells shorten healthy lifespan
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Self-citationDasatinib versus Imatinib in Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia
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InfluentialSelf-citationCellular senescence and senolytics: the path to the clinic
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InfluentialSelf-citation
Metadata
- 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
- ORCID
- Venue
- Nature Medicine
- Published
- 2024-07-02
- Volume
- 30
- Issue
- 9
- Pages
- 2605-2612
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC11705617
- OpenAlex
- W4400248879
- Semantic Scholar
- 0e53cd07806a2b8dfab4ce0f5781c7d52dcac991
- Cited by
- 127
- References
- 39
- Citations by year
- 2026: 67 · 2025: 55 · 2024: 5
- FWCI
- 35.85
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Licence
- 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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-25 (prompt extract-v2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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