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”A tragedy”: The best clinical trial that never was
LEVITY Podcast episode #17 - with XPRIZE Healthspan EVP Jamie Justice
Peter Ottsjö
February 12, 2025
✅ Introduction to episode 17 with Jamie Justice. ✅ Inside the $101 million XPRIZE competition. ✅ Show notes. ✅ What happened to the TAME trial?
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The regulators didn’t stop the TAME trial - the scientists did
The Targeting Aging with Metformin (TAME) trial has achieved an almost mythic status, partly because it has yet to be conducted. The trial's premise is both simple and elegant: to demonstrate that metformin, an affordable diabetes medication, can simultaneously impact multiple age-related conditions. Success could have fundamentally transformed our approach to aging therapeutics, potentially settling the debate over whether aging itself is a disease.
In this episode of the LEVITY podcast, we speak with Jamie Justice, currently the Executive Vice President of XPRIZE Healthspan - a $101 million competition aimed at reversing aging by 20 years. While our discussion primarily focused on XPRIZE*, Jamie provided eye-opening insights into the TAME trial, where she served on its executive committee.
* Which I have also covered in greater detail here.
I was aware that the trial faced funding challenges and that the pandemic caused delays. I also knew that the FDA had approved the project long before these issues. However, Jamie highlighted another significant obstacle: peer review.
”Where the TAME trial ran into trouble was actually peer review. So it was our fellow scientists not accepting a composite endpoint for aging, not accepting the geroscience hypothesis at all […] there are reviewers, our peers, our fellows, [who] did not think that metformin could affect multiple systems. They wanted us to run a trial on cardiovascular outcomes, to run an independent but parallel trial on cognitive outcomes […] run an independent but parallel trial on cancer outcomes, and then add mortality to each one. They didn't believe that one drug could affect multiple... It's that it goes counter to the traditional approach of drug development and clinical trials testing.”
In other words: those reviewers fundamentally missed the whole point.
Now, a decade after its conception, there’s debate about whether metformin remains the best choice for such a trial. Yet, Justice emphasizes that the need for a TAME-like trial - whether with metformin or newer alternatives like GLP-1s or SGLT2 inhibitors - remains critical for the field's advancement.
”It's still a tragedy that it's the best trial that never was. And maybe it's not that it never was, it's that it hasn't started yet”, Jamie tells us.
You can watch the first episode below or listen to it on Spotify, Apple Podcasts or other places, like PocketCasts. Please follow, like and subscribe! 🙏🏼 This will boost our chances of reaching a bigger audience.
A detailed overview of the episode
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