British Institute for Longevity Medicine (BILM) | bilm.org.uk

1. Summary

The British Institute for Longevity Medicine warmly welcomes the PROactive Solutions for Prolonging Resilience (PROSPR) programme from the US Advanced Research Projects Agency for Health (ARPA-H). A major public funder is paying for large, placebo-controlled trials that ask whether existing or new drugs can preserve everyday function as people age, rather than treating one disease at a time.

BILM’s position is:

• PROSPR is rigorous, publicly funded research of the kind the longevity field needs, and BILM supports it.
• None of the drugs being tested is licensed or recommended for ageing in the UK. Results are years away.
• Until those results are available, BILM does not recommend that well people take rapamycin, SGLT2 inhibitors, semaglutide or censavudine to slow ageing (BILM expert consensus; evidence Very low for this use).
• Lifestyle and the NHS-recommended management of blood pressure, cholesterol, blood sugar and weight remain the foundation of healthy ageing.

2. What PROSPR is

Healthspan is the number of years a person lives in good health. Trials of drugs to extend it have been held back because ageing is slow: waiting for disease or disability to appear would take decades. PROSPR aims to identify early biomarkers that track long-term health and to pioneer in-home and decentralised trial designs that can measure ageing-related outcomes within about three years rather than decades [1,2].

ARPA-H has announced seven funded teams. The programme is investing up to US$144 million over five years, through milestone-based contracts rather than grants [1]. The funding covers biomarker discovery, assessment tools and trial design as well as the drug trials described below, not phase 3 trials alone.

3. The trials

3.1 VITAL-H: rapamycin, dapagliflozin and semaglutide

The flagship trial is VITAL-H (Validation and Intervention Testing for Aging, Longevity and Healthspan), led by the Sam and Ann Barshop Institute for Longevity and Aging Studies at UT Health San Antonio, with Dr Elena Volpi as principal investigator. It is funded with up to US$38 million [3,4].

VITAL-H is a phase 3 hybrid trial that will enrol 726 generally healthy adults aged 60 to 65. It has four arms, comparing low-dose rapamycin, dapagliflozin (an SGLT2 inhibitor) and semaglutide (a GLP-1 receptor agonist) with placebo [4,5]. A key aim is to validate intrinsic capacity, the World Health Organization concept of healthy ageing that brings together cognition, mobility, psychological health, vitality and sensory function, as a trial outcome [4,5]. ARPA-H describes the goal as establishing a regulatory pathway for testing the efficacy of drugs that target ageing [3]. Recruitment had not begun as of the most recent public announcement [5].

3.2 Censavudine (TPN-101) and retrotransposons

A second team, with the University of Rochester as prime awardee (lead Professor Vera Gorbunova) and Brown University (lead Professor John Sedivy), has been awarded up to about US$22 million over five years (ARPA-H lists up to US$21.6 million) [6,7,8]. It will test whether censavudine, also called TPN-101, a reverse transcriptase inhibitor originally developed to treat HIV, can suppress retrotransposons. Retrotransposons are stretches of DNA that can copy themselves and are thought to drive chronic, ageing-related inflammation [7,8].

The programme will first test long-term treatment in mice. The planned human trial aims to enrol at least 200 healthy adults aged 60 to 65, who will receive censavudine or placebo for 48 weeks. Outcomes include WHO intrinsic capacity domains, molecular markers of biological ageing, physical performance and overall health [7,8]. This trial is planned and not yet running.

4. Why BILM welcomes PROSPR, and why we remain measured

BILM welcomes PROSPR because it tackles the problems that have held the field back: too few rigorous human trials, and no agreed way to measure whether an intervention slows ageing. Large, placebo-controlled, publicly funded trials with functional outcomes are what the field needs to separate genuine advances from hype.

We nonetheless remain scientifically measured. These are research programmes, not results. Intrinsic capacity has yet to be validated as a trial outcome, the trials are designed to show effects over a few years rather than on lifespan, and any of them may show no benefit or unexpected harm. Positive results would then need regulatory review before any drug could be licensed for an ageing-related indication.

Certainty of evidence that any of these drugs slows ageing in healthy people: Very low.

5. Status in the UK

• None of these drugs is licensed or recommended by NICE or the MHRA for slowing ageing in the UK.
• Rapamycin (sirolimus), dapagliflozin and semaglutide are licensed in the UK only for specific medical conditions [9–12]. Using them for ageing would be off-label and is not supported by BILM outside a trial (BILM expert consensus).
• Censavudine is an investigational drug that has reached phase 2 trials in other conditions; it is not licensed in the UK for any use [13].
• Results from these trials are years away.

6. What this means for you

This is encouraging news for ageing research. Large, carefully designed trials will test whether some medicines can help healthy people in their early 60s keep their strength, mobility, memory and energy for longer.

It is, however, research and not a treatment. None of these medicines is approved in the UK to slow ageing, and the answers will take years. Some of these drugs have real side effects, and it is not known whether their benefits outweigh their risks in healthy people.

Please do not seek these medicines, including online or abroad, to slow your ageing. If you already take one of them for a medical condition, keep taking it as prescribed and talk to your doctor before making any change.

The steps with the strongest evidence for healthy ageing are available now: stay active, eat well, keep a healthy weight, do not smoke, limit alcohol, sleep well, and have your blood pressure, cholesterol and blood sugar checked. If you are 40 to 74 and live in England, the NHS Health Check [14] is a good place to start. BILM will follow these trials closely and update this statement as results appear.

7. References

1. Advanced Research Projects Agency for Health. Research teams to add more healthy years to Americans’ lives as they age [Internet]. Washington (DC): ARPA-H; 2026 Feb 24 [cited 2026 Oct 14]. Available from: https://arpa-h.gov/news-and-events/research-teams-add-more-healthy-years-americans-lives-they-age
2. Advanced Research Projects Agency for Health. PROSPR: PROactive Solutions for Prolonging Resilience [Internet]. Washington (DC): ARPA-H [cited 2026 Oct 14]. Available from: https://www.arpa-h.gov/explore-funding/programs/prospr
3. Advanced Research Projects Agency for Health. VITAL-H: Validation and Intervention Testing for Aging, Longevity and Healthspan [Internet]. Washington (DC): ARPA-H; 2026 [cited 2026 Oct 14]. Available from: https://arpa-h.gov/explore-funding/awards/4176
4. Barshop Institute, UT Health San Antonio. Barshop Institute to receive up to $38 million from ARPA-H, anchoring UT San Antonio as a national leader in aging and healthy longevity science [Internet]. San Antonio (TX): UT Health San Antonio; 2026 Feb 25 [cited 2026 Oct 14]. Available from: https://barshopinstitute.uthscsa.edu/2026/02/25/barshop-institute-to-receive-up-to-38-million-from-arpa-h-anchoring-ut-san-antonio-as-a-national-leader-in-aging-and-healthy-longevity-science/
5. UT Health San Antonio. UT San Antonio to lead $38 million national trial testing drugs to extend healthspan [Internet]. San Antonio (TX): UT Health San Antonio; 2026 Mar 4 [cited 2026 Oct 14]. Available from: https://news.uthscsa.edu/ut-san-antonio-to-lead-38-million-national-trial-testing-drugs-to-extend-healthspan/
6. Advanced Research Projects Agency for Health. Repurposing reverse transcriptase inhibitors to treat aging [Internet]. Washington (DC): ARPA-H; 2026 [cited 2026 Oct 14]. Available from: https://arpa-h.gov/explore-funding/awards/4201
7. Brown University. With federal award of up to $22 million, researchers to study treatment to slow the human aging process [Internet]. Providence (RI): Brown University; 2026 Feb 24 [cited 2026 Oct 14]. Available from: https://www.brown.edu/news/2026-02-24/aging-research-arpa
8. University of Rochester. URochester researchers awarded up to $22M to study a hidden driver of aging [Internet]. Rochester (NY): University of Rochester; 2026 Feb 24 [cited 2026 Oct 14]. Available from: https://www.rochester.edu/newscenter/arpa-h-funding-retrotransposons-aging-695032/
9. Pfizer Limited. Rapamune 1 mg coated tablets: summary of product characteristics [Internet]. Leatherhead: Datapharm, electronic medicines compendium (emc) [cited 2026 Oct 14]. Available from: https://www.medicines.org.uk/emc/product/10398/smpc
10. AstraZeneca UK Ltd. Forxiga 10 mg film-coated tablets: summary of product characteristics [Internet]. Leatherhead: Datapharm, emc [cited 2026 Oct 14]. Available from: https://www.medicines.org.uk/emc/product/7607/smpc
11. Novo Nordisk Ltd. Ozempic 0.25 mg solution for injection in pre-filled pen: summary of product characteristics [Internet]. Leatherhead: Datapharm, emc [cited 2026 Oct 14]. Available from: https://www.medicines.org.uk/emc/product/9748/smpc
12. Novo Nordisk Ltd. Wegovy 0.25 mg FlexTouch solution for injection in pre-filled pen: summary of product characteristics [Internet]. Leatherhead: Datapharm, emc [cited 2026 Oct 14]. Available from: https://www.medicines.org.uk/emc/product/13799/smpc
13. Transposon Therapeutics, Inc. TPN-101 studies [Internet]. Bethesda (MD): National Library of Medicine (US), ClinicalTrials.gov [cited 2026 Oct 14]. Available from: https://clinicaltrials.gov/search?intr=TPN-101
14. NHS. NHS Health Check [Internet]. London: NHS England [cited 2026 Oct 14]. Available from: https://www.nhs.uk/tests-and-treatments/nhs-health-check/

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BILM Position Statement: The ARPA-H PROSPR Programme. British Institute for Longevity Medicine, bilm.org.uk.