What if the biggest obstacle to validating aging clocks isnt the science, but the incentives of clinical drug development? At ARDD 2026 at Harvard, Steve Horvath, pioneer of epigenetic aging clocks and professor at UCLA, highlighted a fundamental conflict between the interests of pharmaceutical companies and the scientific progress needed to make aging clocks useful for regulatory approval. “The more you measure in a clinical trial, the riskier it is for the company. If one indicator goes the wrong way, this may derail the entire approval process. And so there’s a conflict of interest. You don’t want to measure everything under the sun. However, to arrive at qualified surrogate endpoints for aging, we do need to take the risk and measure these data in ideally hundreds of clinical trials.” For me, it represents a fascinating paradox. For aging clocks to become qualified surrogate endpoints, we need extensive longitudinal data demonstrating that changes in biological age reliably predict meaningful clinical benefits. That means measuring multiple aging biomarkers across hundreds of clinical trials, different therapeutic interventions, patient populations, and disease areas. But pharmaceutical companies have incentives to keep their clinical development programs focused. Every additional exploratory measurement potentially introduces an unfavorable result that could complicate interpretation, raise questions, or create additional regulatory scrutiny. What is scientifically valuable for the entire longevity field may not be commercially attractive to an individual drug developer.
This raises an important question: Who should bear the cost and risk of generating the evidence needed to validate aging clocks? Should it be individual pharmaceutical companies, publicly funded initiatives such as ARPA-Hs PROSPR program, or precompetitive consortia that allow companies to share biomarker data without compromising their competitive positions?
The FDAs growing engagement with longevity science makes this question especially timely. We have increasingly sophisticated biological aging clocks. What we still lack is sufficient interventional evidence to establish which of them can reliably predict clinical benefit. The next breakthrough in aging clocks may not be a new algorithm, but the infrastructure and incentives that allow us to validate the ones we already have.#ARDD2026 #Longevity #AgingClocks #Geroscience #ClinicalTrials #Biotechnology #FDA
Aging Research & Drug Discovery Meeting