Advances in research on pharmacotherapy of sarcopenia

Abstract

Sarcopenia is a comprehensive degenerative disease with the progressive loss of skeletal muscle mass with age, accompanied by the loss of muscle strength and muscle dysfunction. As a new type of senile syndrome, sarcopenia seriously threatens the health of the elderly. The first-line treatment for sarcopenia is exercise and nutritional supplements. However, pharmacotherapy will provide more reliable and sustainable interventions in geriatric medicine. Clinical trials of new drugs targeting multiple molecules are ongoing. This article focuses on the latest progress in pharmacotherapeutic approaches of sarcopenia in recent years by comprehensively reviewing the clinical outcomes of the existing and emerging pharmacotherapies as well as the molecular mechanisms underlying their therapeutic benefits and side effects.

Keywords: aging; muscle wasting; pathogenesis; pharmacotherapy; sarcopenia; signaling.

FIGURE 1

Signaling of the pharmacotherapies of sarcopenia. By targeting multiple pathways, such as myostatin (MSTN), renin‐angiotensin system (RAS), androgen receptor (AR), activated protein kinase (AMPK) signaling, potential drugs rebalance protein synthesis and degradation, reshape the endocrine system, reduce oxidative stress and promote mitochondrial function, result in beneficial effects in muscle hypertrophy. Green and red arrows demonstrate promoting and inhibiting effects, respectively. Yellow arrows indicate the pathway of side effect. The indirect impacts are illustrated with dash lines.