Sarcopenia: Can New Drugs Preserve Muscle and Promote Healthy Ageing?: Nature Reviews Drug Discovery | September 2026

Introduction:

Sarcopenia—the age-related loss of skeletal muscle mass, strength, and function—contributes to frailty, falls, fractures, disability, and mortality. Despite its growing burden, there are currently no approved pharmacological therapies, reflecting its complex and multifactorial biology.

Why is this review important?

Ageing affects muscle through mitochondrial dysfunction, impaired autophagy, inflammation, denervation, and reduced anabolic signalling.

Exercise remains fundamental but may be insufficient in advanced sarcopenia.

New mechanistically targeted therapies are rapidly entering clinical development.

GLP-1–associated weight loss has created additional interest in preserving lean muscle during obesity treatment.

Key Takeaways:

NAD+-related therapies and urolithin A aim to improve mitochondrial function.

mTORC1 modulation may restore impaired autophagy and muscle quality.

Myostatin inhibitors promote anabolic signalling and muscle growth.

Selective androgen receptor modulators (SARMs) remain another anabolic strategy.

VEGF and apelin pathways may preserve muscle vascularization.

Targeting inflammatory cytokines could reduce age-related “inflammageing.”

15-PGDH inhibition is particularly interesting because it may improve innervation, regeneration, and muscle anabolism simultaneously.

Trials are increasingly combining GLP-1 receptor agonists with muscle-preserving therapies to prevent excessive lean-mass loss during weight reduction.

Future therapies will likely need to improve strength and physical function—not simply increase muscle mass.

What Does This Review Add?

Sarcopenia drug development is shifting from isolated anabolic approaches toward multi-mechanistic healthy-ageing strategies targeting mitochondrial health, regeneration, inflammation, vascularisation, and neuromuscular function.

Bottom Line:

Sarcopenia is moving from an exercise-only domain toward mechanism-based pharmacotherapy. The most promising future strategies may preserve both muscle quantity and function—particularly important as GLP-1–based weight-loss therapy expands.