Rejuvenate Biomed’s drug combination (metformin & galantamine) shows promise in sarcopenia in Phase 1b trial

This news is especially interesting to our typical forum members because this is a combination of two generic drugs that are easily available today, inexpensively. So, people can try this themselves and report back on results. See details in the discussion thread of this post.

Rejuvenate Biomed’s clinical trial demonstrates the therapeutic potential of RJx-01 in sarcopenia

Cutting-edge therapy shows meaningful improvements in muscle strength, function and fatigue resistance, offering hope for millions suffering from sarcopenia

Diepenbeek, Belgium, February 21st, 2024 – Rejuvenate Biomed NV (“Rejuvenate Biomed"), a pioneering clinical-stage platform and pipeline company committed to enhancing lifelong health through innovative therapeutics, today announces breakthrough functional outcome results from its Phase 1b trial of lead candidate RJx-01 for the treatment of sarcopenia.

Sarcopenia, a condition affecting up to 22% of 65-year-olds and 50% of 80-year-olds, is characterized by the progressive loss of muscle strength and physical performance. This decline not only impacts the quality of life but also elevates the risk of falls, disability, and mortality, particularly among the older population.

RJx-01 is a proprietary combination drug [consisting of metformin and galantamine] that was identified by the Company’s in-house drug discovery platform and has shown to have beneficial effects on various preclinical models of sarcopenia [1]. The recent exploratory clinical trial results, which follow earlier confirmation of safety, tolerability, and pharmacokinetics [2], highlight the potential of RJx-01 in addressing the unmet need for effective sarcopenia treatments.

A first test with 42 healthy volunteers - between 65 and 75 years old - yielded ‘ fantastic ’ results. The participants received a cast around one leg for two weeks. Due to the immobilization they lost muscle strength. Everyone then received a training program. In the participants who received the drug - in the form of spheres - the quadriceps and hamstrings recovered significantly faster. The other participants received a placebo. There was also a statistically significantly better score in terms of muscle fatigue (after longer efforts) and muscle responsiveness (as an indicator of stability).

The results are a first win for Rejuvenate Biomed. ‘ The study with patients continues. That’s a no-brainer. If our treatment stabilizes the disease, that’s quite a lot. That allows for early intervention. But of course we hope for an improvement ’, says Rejuvenate CEO and Founder Ann Beliën.

Sarcopenia has a detrimental impact on the quality of life of the elderly. ‘ I saw it with my father. It starts with walking with a stick, then a walker, then a wheelchair. Having less muscle means no longer being able to open a bottle cap, walking less long distances, struggling to shop for groceries, visiting the grandchildren. It’s about those things. We do not want to run the elderly a marathon, but let them return to normal social life, let them age with mobility. ’

The key findings of the Phase 1b trial with RJx-01 reveal promising functional outcomes:

  1. Improved strength: Participants with disuse-induced sarcopenia treated with RJx-01 exhibited a promising improvement in muscle strength recovery compared to the placebo group. This beneficial effect, assessed through isometric dynamometry, underscores the ability of RJx-01 to promote muscle strength improvement, an outcome that would support the daily activities of sarcopenia patients.
  2. Improved muscle function: Treatment with RJx-01 led to an important improvement of leg acceleration, assessed through isokinetic dynamometry. The ability to accelerate the limb rapidly is important for functional movement in daily activities and is pivotal in mitigating fall risks – a critical consideration for sarcopenia patients.
  3. Improved fatigue resistance: Neuromuscular fatigue was assessed by monitoring muscle parameters during a series of leg exercises. Participants receiving RJx-01 showed a reduced propensity for fatigue indicating that RJx-01 can promote physical activities such as walking, a performance improvement that is important for sarcopenia patients.

Dr. Ann Beliën, Founder and Chief Executive Officer of Rejuvenate Biomed, expressed her enthusiasm, stating: “Today marks a pivotal moment in our journey to address age-related diseases, most notably sarcopenia – a condition affecting up to 1 in 5 individuals over 65 years. The impact demonstrated by RJx-01 offers great potential to make a substantial difference for individuals with sarcopenia or muscle strength loss due to other underlying factors. We eagerly anticipate advancing our Phase 2 program later this year, aiming to substantiate RJx-01’s therapeutic potential in addressing sarcopenia and osteoporosis.”

Prof. Dr. Jean-Yves Reginster, Chair of Rejuvenate Biomed’s Clinical Advisory Board, added: “These compelling data confirm RJx-01’s promise to improve physical performance and muscle strength. With aging populations, it is inevitable that the number of people living with long-term health conditions will rise, challenging one’s functional abilities and overall physical performance. Thus, it is crucial that companies like Rejuvenate Biomed work towards the goal of treating and even preventing the development of age-related diseases such as sarcopenia.”

Prof. Dr. Roger Fielding, Clinical Advisory Board member of Rejuvenate Biomed, echoed his resounding endorsement:The number of people living with muscle-related conditions is increasing, emphasizing the urgent need for viable solutions to improve the age-related decline in muscle performance. The new data announced today by Rejuvenate Biomed regarding RJx-01 are very promising for patients with sarcopenia, as well as for those experiencing a loss of muscle function due to other causes.”

Rejuvenate Biomed will commence a Phase 2 study evaluating RJx-01’s effect on sarcopenia and osteoporosis, as these two diseases often co-exist, so frequently that ‘osteosarcopenia’ has recently been described in medical literature as a distinct syndrome. Additionally, the Company is actively exploring partnership opportunities to investigate RJx-01 in combination with GLP-1 drugs, that are marketed for obesity and diabetes type 2.

The positive outcomes from the Phase 1b trial validate the predictive power of Rejuvenate Biomed’s proprietary drug discovery platforms CombinAgeTM and CelegAgeTM, which efficiently screen small molecules to identify promising therapeutics targeting age-related pathways. Rejuvenate Biomed intends to make these platforms available to third parties through strategic partnerships or licensing agreements.

  1. Tezze C, et al. JCI Insight 2023; 8(15):e168787.
  2. Rejuvenate Biomed - Positive results Phase 1b trial in sarcopenia


(Galantamine + metformin) overview

The combination drug metformin and galantamine (RJx-01) is under development for the treatment of sarcopenia, disuse-induced muscle atrophy and unspecified indication. The drug candidate is a small molecule combination product. It is administered through oral route. It is being developed based on artificial intelligence driven technology platform.


A combination of metformin and galantamine exhibits synergistic benefits in the treatment of sarcopenia

Continue on to Discussion Thread for this Post


Does anyone here supplement with galantamine?

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I’m not.

But, I find it fascinating that Metformin has issues with blocking muscle growth/regeneration by itself, but seems to be a net positive when combined with galantamine.

Galantamine is cheap and available from the usual suppliers. Cost seems to be around 200 to 250 rupees, or about $2.50 to $3.00 per stripe of 10 tablets, so around $0.25 to $0.30 per tablet (4mg tablet), so around $0.07 per mg. This compares to USA prices (using of around $0.10 to $0.14 per mg. But the benefit with the India purchase is of course you can avoid the hassle of trying to find a doctor that will support your experiment.

India Pricing:

Source: Galantamine at Best Price in India

USA Pricing:


I’m not sure if the galantamine ER (extended release) is available in India.


Yes, occasionally. I had no idea that it had any sarcopenia benefits.
It is used by many for lucid dreaming. I use it occasionally for its nootropic effects. It will colorize your dreams and make them more vivid if you take it right before you go to bed.


This is the one I am currently using. I am surprised that it’s not much cheaper from India when you add in the usual shipping cost.

Read the reviews and you will see why most people are taking this.


Also available as a registered drug to treat mild to moderate dementia in Alzheimer’s disease;


This is fascinating. And I’m surprised at how many processes it seems to improve. Lysosomal function is a particularly difficult area to treat. I wonder if this will have an effects on aging beyond sarcopenia.


I like the “lift heavy things” approach to avoiding sarcopenia but I wonder how much this drug would improve my lifts. =)


I agree. I definitely prefer the traditional approach.

Any idea on Dosages needed to help with sarcopenia?


Good question… I’ve done some searching and found info for the earlier mouse trial they did. Perhaps someone can find the human dosing data. In the animal study below, they use 125X more metformin than glantomine. So, if we start with a typical dosing of metformin (say the 1500mg SR metformin used in the TAME trial, that would suggest a daily dose of galantamine of 12mg/day.

Here is what I found in the article below (interestingly, they are injecting it in the mouse study):

Accordingly, the investigators examined whether RJx-01 could mitigate inflammation and denervation while preserving these two primary functions. First, sarcopenic mice were injected with RJx-01, containing 410 mg/kg metformin and 3.28 mg/kg galantamine. Then, sarcopenic mice underwent strength and conditioning testing.


The investigators found that RJx-01 significantly improved muscle strength, with treated mice exerting over 38% more muscle force than untreated controls. They also showed that treated mice ran significantly longer (3-fold increase) during the treadmill test than their untreated counterparts, suggesting that RJx-01 preserves muscle function and endurance. Moreover, untreated mice exhibited much higher inflammation and denervation than treated mice, indicating that RJx-01 improves muscle performance and fitness by suppressing inflammation and hindering denervation.

(Tezze et al., 2023 | JCI Insight) RJx-01 enhances physical performance and fitness. (Left) Mice treated with RJx-01 (purple) have fewer denervated fibers than untreated mice (black) and mice treated with metformin (blue) or galantamine (orange) alone. (Middle/Right) Treated mice run significantly longer and exert more muscular force than all other experimental groups.

Notably, the findings demonstrate that metformin and galantamine likely work in synergy, as treatment with either metformin or galantamine alone failed to promote similar protective effects in sarcopenic mice. Following testing in sarcopenic mice, Tezze and colleagues proceeded to conduct similar testing in naturally aged mice (22 months old ~ 64 human years) to further elucidate RJx-01’s synergistic effects. The results showed that RJx-01 enhanced grip strength by 32%, increased running endurance, and reduced denervation, corroborating the data seen in sarcopenic mice and confirming RJx-01’s synergistic effects.


Still looking for information on the dosing used in the Phase 1b clinical trial RJx-01-101

No luck yet - but this pitch deck is interesting:

Rejuvenate-Biomed-Pitch-Deck-Longevity.Technology.pdf (3.0 MB)


Searching on sarcopenia on the Clinical Trials website, but it doesn’t seem to be linked with the company in these files:

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The company presentation on this new drug combination:


These summary graphs below seem pretty impressive (I think this is from the mouse studies).

If anyone already taking metformin decides to add galantamine to their regimen (@rberger , @DeStrider , etc ) please report back. I also wonder what the effect of this drug combo would be on regular non-sarcopenia people who are exercising.

In the animal studies they are reporting using Metformin Dose at 125X the Galantamine dose. So, if taking 1500mg SR metformin, that would be 12mg of galantamine to take a day with the metformin. Is there a slow release version of galantamine, as there is with metformin? (ah yes, there is, just found it):

Generic name: galantamine [ ga-LAN-ta-meen ]
Brand names: Reminyl, Razadyne, Razadyne ER
Dosage forms: oral capsule, extended release (16 mg; 24 mg; 8 mg), oral solution (4 mg/mL), oral tablet (12 mg; 4 mg; 8 mg)
Drug class: Cholinesterase inhibitors

Source: Galantamine Uses, Side Effects & Warnings

Do some pre-testing, and post testing over a month or two… I think I may try to get my 92 year old father to try this.


Your father is 92 and still in good shape! What do you think his secrets are? What are his stacks?

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He’s not in great shape… and isn’t into longevity much, so other than longevity, not a model we want to follow. He tried rapamycin for a while, but didn’t continue, but I think I’ll try him again on it. And I want to try this drug combo to improve strength… he’s definitely got sarcopenia.


I’m a ways off from sarcopenia, but my parents may be interested.

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What I can’t tell is whether or not the control group exercised. In other words, did the study compare “mice who took the drug against mice who didn’t take the drug and didn’t exercise” or “mice who took the drug against mice who didn’t take the drug but DID exercise”? If the drug doesn’t do significantly more for you than exercising, I’ll pass, although there are certainly people who can’t or won’t exercise who would benefit.

From what I can tell, in the mouse study they tracked the exercise of the control and treated mice, but did not force them to exercise (is it possible to force mice to exercise in these types of studies? I’m not sure…).

Here is what it says:

Physical performance

Opa1–/– mice.

The concentric training protocol consisted of the treadmill (Biological Instruments, LE 8710 Panlab Technology 2B) running to exhaustion, with no incline and a constant speed of 13 cm/s. Total running time was recorded for each mouse.

The in vivo muscle force is measured as previously described (41). Briefly, animals were deeply anesthetized, and the foot was mounted on a 305B muscle lever system (Aurora Scientific). The knee was blocked, and an electrical stimulation was applied to the sciatic nerve, inducing the isometric plantar flexion of the foot. The force-frequency curve was obtained by stimulating at increasing frequencies (starting with a single depolarization up to 150 Hz). Force was normalized to the weight of gastrocnemius and plantaris muscles to estimate specific force. Animals were then sacrificed by cervical dislocation according to the approved animal protocols, and muscles were dissected, weighed, and frozen. Experimental data were analyzed using a self-compiled program in LabView.

Aged mice.

At baseline and 18 weeks after treatment, mice performed concentric exercise on a treadmill (Biological Instruments, LE 8710 Panlab Technology 2B), as previously described (42). Total running time was recorded for each mouse.

Grip strength.

The grip strength was measured on forelimbs at baseline and 18 weeks after treatment using a commercially available Bioseb Grip Test device (Bioseb) as described previously (43).

From here: A combination of metformin and galantamine exhibits synergistic benefits in the treatment of sarcopenia - PMC