Investigating the effects of everolimus on aging and insulin resistance
Clinical Evaluation of mTORC1 Inhibition for Geroprotection
This study is testing if a medication called everolimus can help older adults who are insulin resistant or prediabetic improve their health and aging markers.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 88 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | University of Wisconsin, Madison Academic / other |
| Drugs / interventions | methotrexate, prednisone |
| Locations | 1 site (Madison, Wisconsin) |
| Trial ID | NCT05835999 on ClinicalTrials.gov |
What this trial studies
This clinical trial aims to evaluate whether the mTOR inhibitor everolimus can safely improve physiological and molecular markers of aging in adults aged 55-80 who are insulin resistant or prediabetic. Participants will be randomized to receive either daily or weekly doses of everolimus or a placebo over a period of 24 weeks. The study will utilize a double-blinded, randomized, placebo-controlled design and will assess various domains of aging, including metabolic, cardiac, cognitive, and physical functions, while monitoring for adverse events. The trial seeks to determine the safety and efficacy of everolimus in promoting healthy aging.
Who should consider this trial
Good fit: Ideal candidates for this study are adults aged 55-80 who are insulin resistant or prediabetic.
Not a fit: Patients who are younger than 55 or do not have insulin resistance or prediabetes may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could provide a novel therapeutic approach to improve health outcomes and quality of life for older adults facing age-related conditions.
How similar studies have performed: While the use of mTOR inhibitors like rapamycin has shown promise in animal models, this approach in humans is still largely untested and novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: Adults aged 55-80 years old * Free of overt chronic disease * Willing to provide informed consent * Willing to comply with all study procedures and be available for the duration of the study * Able to use and be contacted by the telephone * Ability to take oral medication * Insulin Resistant defined by HOMA-IR greater than or equal to 1.5 or prediabetic defined as: * impaired fasting glucose (100-125 mg/dL) * HbA1c (5.7-6.4 percent) * glucose 2 hours after a 75 gram oral glucose tolerance test (140-199 mg/dL) * previous diagnosis of prediabetes in the past year * Not planning to change diet or physical activity status * Adequate organ function as indicated by standard laboratory tests: hematology (complete blood count), clinical chemistry and urinalysis * Females of childbearing potential must have a negative urine pregnancy test before DEXA and before the oral glucose tolerance test (OGTT). A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: * Has not undergone a hysterectomy or bilateral oophorectomy; or * Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months) * Women of childbearing potential in sexual relationships with men must use an acceptable method of contraception from 30 days prior to enrollment until 4 weeks after completing study visits. Males must agree to avoid impregnation of women during and for four weeks after completing study visits through use of an acceptable method of contraception. * Note: Includes, but is not limited to, barrier with additional spermicidal foam or jelly, intrauterine device, hormonal contraception (started at least 30 days prior to study enrollment), intercourse with men who underwent vasectomy. Inclusion Criteria: Younger Adults aged 18-35 (No intervention) * Free overt chronic disease Exclusion Criteria: * Pregnancy or breastfeeding * Heart disease * Cerebrovascular disease * Cancer or less than 5 years in remission * Chronic respiratory disease * Chronic liver disease * Diabetes * Alzheimer's * Chronic kidney disease * Problems with bleeding, on medication that prolongs bleeding time (if subject cannot safely stop prior to biopsy) * Taking azathioprine (Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), dexamethasone (Decadron, Dexpak), methotrexate (Rheumatrex, Trexall), prednisolone (Orapred, Pediapred, Prelone), prednisone (Sterapred), sirolimus (Rapamune), and tacrolimus (Prograf) or other medications proposed to lower the immune system. Daily use of high potency topical corticosteroids used on greater than or equal to 10% of body surface area will not be eligible. Nasal sprays or inhaled corticosteroids will be reviewed on a case-by-case basis. * Taking strong or moderate CYP3A4 and/or P-glycoprotein (PgP) inhibitors * Taking strong CYP3A4 activators * Taking daily NSAIDs with the exception of baby asprin (81 mg) * Subjects who are not willing to restrict the use of grapefruit, grapefruit juice, and other foods that are known to inhibit cytochrome P450 and PgP activity and may increase everolimus exposures and should be avoided during treatment * Subjects who are not willing to restrict the use of St. John's Wort (Hypericum perforatum) because it may decrease everolimus exposure unpredictably * Subjects who are not willing to avoid blood donations 8 weeks prior to the first visit and 8 weeks after the last visit * For those undergoing MRI, contraindications with MRI which could include metal on your body * Low white-blood cell count (\<4,000 cell/µL) * History of stomatitis or ulcers in the mouth * Those on glucose lowering drugs * Participating in intensive exercise training program (high to moderate intensity exercise greater than 150 minutes per week) or planning to start new exercise program during study period * Tobacco use * Allergies to lidocaine or everolimus * Subjects currently enrolled in other clinical trials. Subjects may be eligible after a washout period that will be reviewed on a case by case basis. * Individuals with limited English proficiency * Subjects who are planning to have elective surgery 12 weeks prior to or during the intervention
Where this trial is running
Madison, Wisconsin
- University of Wisconsin-Madison — Madison, Wisconsin, United States (Recruiting)
Study contacts
- Principal investigator: Adam Konopka, PhD — University of Wisconsin, Madison
- Study coordinator: Everolimus Aging Study Team
- Email: everlast@medicine.wisc.edu
- Phone: 608-228-2978
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.