Key Points:
- The therapies developed by companies advancing to the final round aim to restore muscle, cognitive, and immune function with advanced age and are moving on towards human trials.
- The therapeutics undergoing testing include NAD+ nasal spray, spermidine, peptides, rapamycin, cell and gene therapies, extracellular vesicles, exercise programs, and a capsule containing undisclosed Chinese herbs and probiotics.
The Healthspan XPrize (named with the word “healthspan,” denoting the duration of life lived in overall good health) offers a $101 million purse for teams that can test an aging intervention that shows the restoration of muscle, cognition, and immune function in older adults. With the name of the prize in mind, restoring these three domains could offer significant ways to extend aged individuals’ healthspan.
| Award Stage / Outcome | Award Amount |
| ≥10 years of functional restoration in all three domains | $61 million |
| ≥15 years in all three domains | $71 million |
| ≥20 years in all three domains | $81 million |
| Milestone 1 awards | $250,000 per selected team |
| Milestone 2 awards | $1 million each for 10 teams; $10 million total |
| Separate FSHD Bonus Prize | $10 million purse |
Peter Diamandis (an American physician, entrepreneur, and investor) is the founder and executive chairman of the XPrize Foundation (a nonprofit organization that created the XPrize Healthspan). Also, two co-sponsors who have contributed substantially to the $101 million prize are the Hevolution Foundation (a Saudi Arabia-based nonprofit focused on extending healthy human lifespan) and Chip Wilson (founder and chairman of SOLV FSHD, a venture philanthropic organization).
Interestingly, in August 2026, the XPrize Foundation named 20 finalist teams for the XPrize Healthspan, with 10 teams each receiving the prize’s $1 million Milestone 2 pool award, meant for application to human trial testing. Accordingly, the 10 teams that received the Milestone 2 award will apply it toward the next stage of clinical trial development of their respective therapeutic. These clinical trials will run through 2029, and the grand prize decision division is planned for 2030.
Core Innovations from the 10 Teams That Received the $1 Million Milestone 2 Award
AgelessRx
AgelessRx is a longevity-focused company that uses telehealth services (giving medical advice and prescriptions via phone or online communication) to deliver physician-supervised longevity medicine, along with prescriptions for purported pro-longevity medicines. Accordingly, their telehealth-based protocol combines a swath of aging interventions with a resistance exercise regimen. The core innovations the company has developed for the Healthspan XPrize competition include mTOR inhibition, AMPK activation, NAD+ replenishment, oxidative stress reduction, and enhancement of growth hormone signaling.
- In more detail, mTOR inhibition is believed to suppress the process of aging since the cellular mTOR protein acts as a nutrient sensor and cell growth-permitting signal. As such, persistently high mTOR activity favors cell and tissue growth and suppresses cellular repair. Inhibiting mTOR signaling shifts cells toward maintenance, recycling, and stress resistance, thus purportedly promoting longevity. In multiple animal models, pharmacological reduction of mTOR signaling extends lifespan and delays age-related physiological dysfunction.
- Also, AMPK activation is believed to promote longevity because AMPK is a vital enzyme found in every cell that acts as an energy and stress sensor. When cellular energy levels fall, AMPK turns on. Subsequent activation shifts cells away from energy-intensive growth and toward energy production, repair, recycling, and stress resistance—processes that tend to erode with age.
- Moreover, some researchers believe NAD+ replenishment may help with aging because NAD+ is a core molecule involved in cellular energy production, as well as DNA and cell repair. In line with these effects, age-related reductions in NAD+ availability may contribute to declining cellular resilience; replenishing it is intended to restore those functions.
- Additionally, oxidative stress arises from the buildup of harmful, reactive molecules, and it can damage DNA, proteins, lipids, and cellular powerhouses (mitochondria). Reducing oxidative stress may therefore slow processes that contribute to cellular dysfunction, the age-related accumulation of dysfunctional cells (senescent cells) in tissues, inflammation, and ultimately, age-related diseases.
- Finally, enhancing the signaling of the small protein called growth hormone can counter certain age-related deficits, such as loss of lean muscle mass, dysfunctional bone remodeling, and impaired muscle recovery. However, in longevity biology, growth hormone is widely believed to increase mTOR signaling, and reduced, not increased, signaling of mTOR extends the lifespan of multiple animal models. Thus, AgelessRx scientists likely view enhancing growth hormone signaling as a trade-off between the hormone’s beneficial effects on muscles and bones and the potentially adverse effects from increased mTOR signaling.
The combination of compounds in AgelessRx’s protocol includes the following:
- To suppress mTOR, AgelessRx uses rapamycin (an immunosuppressive medication repurposed to promote longevity).
- AgelessRx’s combination treatment also contains low-dose naltrexone (a prescription medication used to treat alcohol use disorder and opioid use disorder). Although no evidence proves that this drug slows aging, researchers are studying low-dose naltrexone for possible effects against inflammation and improvement of immune signaling.
- The company’s treatment protocol also includes metformin (a diabetes medication). Researchers are studying whether metformin’s effects on metabolism, inflammation, and cellular stress responses might improve healthspan.
- Additionally, the final protocol specifies the inclusion of NAD+ nasal spray. As such, increasing NAD+ may help improve cellular energy production, DNA repair, and immune signaling.
- The protocol contains glutathione, as well, which is a molecule that cells make to protect against oxidative stress.
- The protocol contains sermorelin, which is a peptide (consisting of a chain of protein building blocks [amino acids]) that causes the release of growth hormone. It activates receptors in a tiny, pea-sized gland located at the base of the brain (the pituitary gland) and causes a region of the pituitary gland to release growth hormone in pulses.
- AgelessRx’s treatment protocol also contains tirzepatide, an injectable medicine that activates the gut hormone receptor GLP-1. In response to elevated blood sugar, tirzepatide increases insulin release, reduces inappropriate glucose output from the liver, and acts to suppress appetite.
In addition to all of the listed compounds in the protocol, clients and study participants also receive a proprietary blend of supplements, as follows:
- The blend includes alpha-ketoglutarate, a molecule that supports cellular energy production.
- Also among the supplements is quercetin, a plant-derived molecule that acts as an antioxidant as well as a potential senolytic (an intervention that selectively triggers the death of harmful, persistent senescent cells).
- The blend also contains carnosine, a naturally occurring peptide that consists of two linked amino acids. Carnosine helps buffer the increased acidity associated with exercise, potentially delaying fatigue during bouts of physical activity.
- The supplement blend also contains pterostilbene, another plant-derived molecule that has been reported in animal model research to improve inflammation and metabolism.
- Also included is astaxanthin, a carotenoid with antioxidant properties, produced principally by certain microalgae and other microorganisms and accumulated by some marine animals
- The supplement blend also contains curcumin, a molecule from the yellow-orange spice turmeric. In animal models, curcumin has been found to have anti-inflammatory and antioxidant effects.
- Also included in the supplement is glucosamine, an sugar found in human cartilage and joint fluid. It acts as a core building block for tissues that cushion joints. As an over-the-counter dietary supplement, it is widely used to ease joint pain.
In combination with their aforementioned prescription of an exercise regimen, AgelessRx has begun testing these compounds in a 90-day pilot human trial and is preparing to test the expanded final protocol. They hope to improve muscle, cognitive, and immune function. Not only that, but the company also claims that its telehealth platform has prescribed individual components to more than 100,000 clients.
Goda Lab (University of Tokyo/ NanoTitan/ Tohoku University/ Tokyo Relife Clinic)
The Goda Lab team has developed a therapy meant to rejuvenate muscle, cognitive, and immune function in aging adults. To do so, they have engineered tiny, membrane-enclosed particles (extracellular vesicles) derived from stem cells as well as the fluid that carries blood cells (plasma).
Its proprietary platform for extracellular vesicle delivery, called super homotypic targeting (SHT), alters extracellular vesicle surfaces. These alterations purportedly enhance the delivery of molecular cargo (meant to rejuvenate tissues) to aged and dysfunctional tissues. Moreover, the team has designed their therapy to address multiple hallmarks of aging simultaneously, rather than treating individual age-related diseases.
The lab claims that in aged mice, SHT-altered extracellular vesicles slowed age-related frailty (characterized by loss of muscle strength and mass) and extended lifespan by more than 10 months (the equivalent of about 40 years for humans). Treated mice also showed less hair loss and greying than controls. By targeting multiple hallmarks of aging simultaneously, the team says their therapy has the potential to preserve physical mobility, immune function, and other facets of physiology that deteriorate with age for the extension of healthspan.
Johns Hopkins—Suninflam
Johns Hopkins—Suninflam, a team from Johns Hopkins University and the biotech company Suninflam, is developing an antibody therapy called SIF001. SIF001 is meant to target the early stages of Alzheimer’s disease or the condition widely recognized as preceding it, mild cognitive impairment, in adults aged 65 and older. The team claims that in an apparently unpublished human trial involving SIF001, researchers reported that patients with moderate-to-severe Alzheimer’s disease showed improved cognitive function and reduced seizures. The team characterizes their antibody therapy as acting on immune function and suppressing inflammation, with hopes that it will extend healthspan. However, public human evidence for SIF001 is currently limited to a six-patient, open-label case series in drug-resistant epilepsy. The report described reduced seizure frequency but did not report cognitive improvement or results in moderate-to-severe Alzheimer’s disease.
Longeveron Inc.
Longeveron is a biopharmaceutical company that focuses on tackling age-related frailty, immune dysfunction, and Alzheimer’s disease. It has an investigational product called laromestrocel, containing allogenic bone marrow-derived stem cells (called mesenchymal stem cells) as the core component.
With laromestrocel, the company aims to treat multiple age-related conditions. They believe their stem cell therapy has the potential to promote vascular function, enhance immunity, and improve tissue repair.
For cognitive decline, the company hopes the stem cell therapy will delay Alzheimer’s disease through anti-inflammatory and mitochondrial-enhancing effects. Accordingly, these potential effects of their therapy could offer a neuroprotective means of addressing age-related cognitive decline by addressing some root causes of neuronal death (i.e., inflammation and mitochondrial dysfunction).
Furthermore, the anti-inflammatory effect of laromestrocel may also treat the low-grade, sterile systemic inflammation (known as inflammaging) associated with aging. Targeting inflammaging may also serve as a way to treat other age-related conditions, aside from Alzheimer’s and cognitive decline, simultaneously.
Published human trial data the selected laromestrocel dose produced a statistically significant 63.4-meter improvement over placebo in six-minute walking distance at nine months. The precise mechanisms by which laromestrocel potentially confers this effect remain under active investigation. However, the company reports that the stem cells secrete proteins and types of extracellular vesicles called exosomes that can target cells in various tissues throughout the body, including muscles.
Minicircle
Minicircle is a biotech company developing a gene therapy platform. The current gene therapy platform is designed to make cells produce and secrete follistatin, a protein that normally restrains skeletal muscle growth, and klotho, a protein linked to conferring pro-longevity effects. Through its aim of increasing follistatin and klotho, the company wants to target muscle and systemic aging pathways, respectively.
The company claims that apparently unpublished prior data from a follistatin-only human trial reported no adverse events, with lean muscle mass gain, body fat reduction, and a reduction in epigenetic age (an age assessment based on molecular tagging patterns on DNA). Although approximately one-third of recipients reportedly experienced a small increase in LDL cholesterol. Furthermore, no published, peer-reviewed human efficacy or safety data for klotho gene therapy appear to be available yet.
NYC-Vita
NYC-Vita is a team of more than 30 experts from the New York City-based Mount Sinai Healthspan Program, an academic health initiative combining physician-led preventive care with research on the biology of aging. The experts integrate their knowledge in inflammation, muscle biology, and cognitive health.
Their platform therapy aims to target metabolic, muscle, and cognitive decline associated with inflammaging. The components of the platform are rapamycin (an mTOR inhibitor), spermidine (a compound that promotes the recycling and elimination of dysfunctional cellular components), and a structured exercise regimen to drive tissue repair. Currently, NYC-Vita has not produced public human trial results related to its platform.
Mitochondrial All Stars
The Mitochondrial All Stars is an academic collaboration that combines mitochondrial and drug development experts from private companies, as well as institutions like the University of Washington. Their goal is to advance a novel approach to healthspan extension.
This collaboration has put forth the first and only FDA-approved mitochondria-targeting peptide—elamipretide—as an aging intervention in older adults. Elamipretide binds to a type of fat within mitochondria, and published research has demonstrated the peptide’s ability to improve mitochondrial function in various models of aging, including in older humans. In the human study, a single dose of elamipretide produced a transient increase in skeletal-muscle mitochondrial ATP production. According to the collaborators, such effects on mitochondria have been associated with improved brain and muscle function, as well as reduced markers of systemic inflammation. Hence, the Mitochondrial All Stars have planned a human trial that will measure elamipretide’s effects on muscle and cognitive function.
Retro-Epigerna
Retro-Epigerna is a collaboration of researchers from the Macau University of Science and Technology in China. Their candidate therapy, KYN Composite Capsule, combines unspecified Chinese herbs and probiotics (beneficial live microorganisms [usually bacteria]). The group generated the KYN Composite Capsule based on a discovery linking a chemical modification on a certain type of cellular RNA to aging. Accordingly, the capsule purportedly restores this modification.
In purportedly restoring this modification, the KYN Composite Capsule aims to restore protein production from DNA, mitochondrial function, and immune resilience. In doing so, the group hopes to rejuvenate multiple organ systems and reverse the overall aging process.
In an unpublished human trial with older adult participants, the group reported improved muscle function and markers of immune function, as well as stable scores on assessments of cognition (the group attributes a lack of improvements in cognition to the short duration of the trial). While no commercial deployment of the KYN Composite Capsule has ensued, the group claims that pilot deployments in Japan and China have validated real-world effects. Although independently verifiable evidence of real-world effectiveness was not located.
RPRGAON (PRG S&TECH) – PROGERININ
PRG S&TECH is a South Korean biotech company. They have previously focused their research on Hutchinson-Gilford Progeria Syndrome (HGPS), a rare disorder that produces features resembling accelerated aging, particularly in the cardiovascular, skeletal, skin and connective-tissue systems . HGPS is most commonly caused by a recurrent mutation (specifically, an LMNA mutation) independently identified by research groups in 2003. The team developed Progerinin, a small molecule that selectively degrades the protein (progerin) that results from the mutation.
The team frames Progerinin and the mechanism by which it eliminates the dysfunctional progerin protein as relevant beyond HGPS, since progerin is also implicated in tissues affected by natural aging (arteries, muscle, and fat tissue). The team believes Progerinin can reverse cellular senescence and improve the stability of the genome as well. Preclinical studies suggest that Progerinin can improve certain disease-associated cellular characteristics in HGPS models, but systemic reversal of senescence or genomic instability has not been demonstrated in humans.
As for human trial evidence behind Progerinin, a four-week study in 21 women that applied a topical serum containing Progerinin to the skin showed a 23.6% improvement in the thick, middle layer of the skin. According to the team, this finding supports Progerinin’s broad potential as an aging intervention. However, the small topical study does not establish systemic anti-aging efficacy or the effectiveness of orally administered Progerinin. As such, PRG S&TECH has planned human trials that will give Progerinin via oral capsules in general aging populations.
TIME TRAVELER – PLANT-EVS
TIME TRAVELER CORPORATION (TT) is a biotech company based in Tokyo that aims to integrate prevention and treatment options to advance longevity and extend human healthspan. The company has two core businesses: one with healthcare products that utilize plant-derived extracellular vesicles and another that investigates high-potential drugs targeting aging-related proteins.
For the XPrize Healthspan competition, TT has put forth a technology from its plant-derived extracellular vesicle branch of business. The plant-derived extracellular vesicles in the competition are designed to alleviate the age-related decline in physical function and help mitigate age-related frailty.
More specifically, the company reports selecting parsley-derived extracellular vesicles as its lead XPRIZE therapy after screening extractions of more than 140 edible plant species, representing about 95% of the vegetables available in Japan. The screening evaluated the vesicles’ anti-inflammatory and anti-senescence properties. The screening helped to establish a proprietary formula of multiple promising plant-derived extracellular vesicle candidates, selected as the initial lead product put forth in XPrize Healthspan.
The company claims that an unpublished human trial of aged sedentary adults who were at risk for physical decline demonstrated that the plant-derived extracellular vesicles hold promise to mitigate age-related declines in muscle strength and support physical performance. This result warrants further human trial testing to validate the potential of plant-derived extracellular vesicles to help sustain physical function and promote healthy longevity.
The Next Phase Will Entail the Announcement of the $81 Million Grand Prize in 2030
Following this announcement of the 20 finalists for the XPrize Healthspan competition, human trials are expected to run from 2026 through 2029 under the competition’s coordinated clinical testing framework. Each company will test the interventions they put forth. In 2030, XPRIZE may award a grand prize of $61 million, $71 million, or a whopping $81 million, depending on the highest qualifying level of functional improvement demonstrated across all three domains.
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