Evidence map›Paper›PMID 39292659›Full record

ArticlePloS one2024

Rationale and protocol for a safety, tolerability and feasibility randomized, parallel arm, double-blind, placebo-controlled, pilot study of a novel ketone ester targeting frailty via immunometabolic geroscience mechanisms.

Brianna J Stubbs, Gabriela Alvarez Azañedo, Sawyer Peralta, Stephanie Roa Diaz, Wyatt Gray, Laura Alexander, Wendie Silverman-Martin, Thelma Y Garcia, Traci M Blonquist, Vaibhav Upadhyay and 3 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06645847 (A Randomized, Double-blind, Placebo-controlled, Parallel Group, Pilot Study to Evaluate the Effect of a Ketone Ester on Muscle and Immune Function in Older Men and Women Who Are at Risk for Strength and Mobility Decline), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06645847 narecruitingnot on this mapstarted 2025, after this paper: background citation

A Randomized, Double-blind, Placebo-controlled, Parallel Group, Pilot Study to Evaluate the Effect of a Ketone Ester on Muscle and Immune Function in Older Men and Women Who Are at Risk for Strength and Mobility Decline

TypeinterventionalSponsorBuck Institute for Research on AgingRan2025 to 2028Enrolled180ConditionsFrail Elderly, Aging, Immune Function, Muscle FunctionArmsKetone ester, Placebo Comparator: Non-ketone placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Brianna J StubbsBuck Institute for Research on Aging, Novato, California, United States of America.ORCID 0000-0001-9566-9134
Gabriela Alvarez AzañedoBuck Institute for Research on Aging, Novato, California, United States of America.
Sawyer PeraltaBuck Institute for Research on Aging, Novato, California, United States of America.
Stephanie Roa DiazBuck Institute for Research on Aging, Novato, California, United States of America.
Wyatt GrayBuck Institute for Research on Aging, Novato, California, United States of America.
Laura AlexanderBuck Institute for Research on Aging, Novato, California, United States of America.
Wendie Silverman-MartinBuck Institute for Research on Aging, Novato, California, United States of America.
Thelma Y GarciaBuck Institute for Research on Aging, Novato, California, United States of America.
Traci M BlonquistBiofortis, Mérieux NutriSciences, Addison, Illinois, United States of America.
Vaibhav UpadhyayDepartment of Microbiology & Immunology, UCSF, San Francisco, California, United States of America.
Peter J TurnbaughDepartment of Microbiology & Immunology, UCSF, San Francisco, California, United States of America.
James B JohnsonDepartment of Medicine, UCSF, San Francisco, California, United States of America.
John C NewmanBuck Institute for Research on Aging, Novato, California, United States of America.

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI W. JOHN BOSCARDIN · 2013 to 2026
$19.9M
Skeletal Biology and Biomechanics (SBB) CoreP30AR075055 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI EDWARD C HSIAO · 2019 to 2026
$7.1M
Exogenous ketones target geroscience pathways and ameliorate geriatric syndromesK01AG078125 · NIA · BUCK INSTITUTE FOR RESEARCH ON AGING · PI Brianna Jane Stubbs · 2022 to 2026
$870k
Impact of gut bacterial metabolites on lung function and diseaseK08HL165106 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Vaibhav Upadhyay · 2023 to 2026
$676k
NHLBI NIH HHS K08 HL165106NIAMS NIH HHS P30 AR075055NIA NIH HHS K01 AG078125NIA NIH HHS P30 AG044281
6 · The paper itself

Abstract

backgroundFrailty is a geriatric syndrome characterized by chronic inflammation and metabolic insufficiency that creates vulnerability to poor outcomes with aging. We hypothesize that interventions which target common underlying mechanism of aging could ameliorate frailty. Ketone bodies are metabolites produced during fasting or on a ketogenic diet that have pleiotropic effects on inflammatory and metabolic aging pathways in laboratory animal models. Ketone esters (KEs) are compounds that induce ketosis without dietary changes, but KEs have not been studied in an older adult population. Our long-term goal is to examine if KEs modulate aging biology mechanisms and clinical outcomes relevant to frailty in older adults.

objectivesThe primary objective of this randomized, placebo-controlled, double-blinded, parallel-group, pilot trial is to determine tolerability of 12-weeks of KE ingestion in a broad population of older adults (≥ 65 years). Secondary outcomes include safety and acute blood ketone kinetics. Exploratory outcomes include physical function, cognitive function, quality of life, aging biomarkers and inflammatory measures.

methodsCommunity-dwelling adults who are independent in activities of daily living, with no unstable acute medical conditions (n = 30) will be recruited. The study intervention is a KE or a taste, appearance, and calorie matched placebo beverage. Initially, acute 4-hour ketone kinetics after 12.5g or 25g of KE consumption will be assessed. After collection of baseline safety, functional, and biological measurements, subjects will randomly be allocated to consume KE 25g or placebo once daily for 12-weeks. Questionnaires will assess tolerability daily for 2-weeks, and then via phone interview at bi-monthly intervals. Safety assessments will be repeated at week 4. All measures will be repeated at week 12.

conclusionThis study will evaluate feasibility, tolerability, and safety of KE consumption in older adults and provide exploratory data across a range of aging-related endpoints. This data will inform design of larger trials to rigorously test KE effects on aging mechanisms and clinical outcomes relevant to frailty.

Indexed as

EstersFrailtyKetonesAgedAged, 80 and overAgingDouble-Blind MethodFeasibility StudiesFemaleHumansMalePilot ProjectsQuality of LifeRandomized Controlled Trials as TopicEstersKetones

Identifiers

PMID39292659
PMCPMC11410252

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.