A representative selection of therapeutic anti-aging clinical trials is examined within this section to gain an overall view of the past, present, and future state of clinical development. A selection of the top 10,000 anti-aging clinical trials 664 from is examined against time, clinical trial phase, status, disease indication, and anti-aging strategy. Anti-aging therapeutics are well established in clinical development, with Figure showing a steady growth starting in the early 1990s and continuing through 2022. Analysis of therapeutic anti-aging clinical trial phases reveal that close to half of all trials are in Phase III and IV with the other half filtering into earlier phases. Phase II trials contain the highest percentage of all categories encompassing 33% of all trials (Supporting Information, Figure ). Examining clinical trials, a step further, by disease indication, shows that bone, cardiovascular, and skin diseases along with sleep disorders and obesity are well established in the development pipeline having the highest percentage of clinical trials further along in phase III and IV clinical trials (Figure ). Balance disorders, cancer, frailty, along with eye and neurological disease are the indications less established in the pipeline with the largest percentage of trials in earlier phases (Figure ). Next, we review therapeutic anti-aging clinical trial statuses, characterized by age-related disease indications. Current therapeutic anti-aging clinical trials in early phase trials such as neurological disease, frailty, sleep disorders, and cancer also have the highest percentage in active, recruiting, and not yet recruiting statuses (Figure ). These early phase trials are active or getting ready to be active in the pipeline. On the other hand, it is no surprise that disease indications more well established in the development pipeline such as skin, bone, and eye diseases along with obesity also contain the highest percentage of completed trials. There is however still current advancement in these areas reflected by greater than 20% of their trials in active, recruiting or not net recruiting status (Figure ). mTOR inhibition is widely explored in clinical trials for anti-aging therapeutics. The National eye institute researched the use of rapamycin for the treatment of geographic atrophy (GA), as part of latestage age-related macular degeneration (AMD) in phase I/II clinical trial NCT01445548. Six participants with bilateral GA were enrolled and received intravitreal sirolimus but no benefit was detected. A following phase II study NCT01675947 enrolled 52 participants with GA for monthly intravitreal sirolimus treatment. The study was terminated early due to lack of efficacy and the adverse event of sterile endophthalmitis in three participants. It was determined that while immunosuppression may play some role in AMD, it might not be the main pathway for GA development. The Mayo Clinic also researched at the use of rapamycin in phase I clinical trial NCT01649960. They focused on rapamycin treatment effects on senescence markers and frailty in elderly subjects undergoing cardiac rehabilitation. 13 participants received low doses (0.5mg-2mg) of rapamycin daily for 12 weeks. While correlation between some senescence markers and physical performance were observed, the primary endpoint measurement of frailty saw no improvement. 667 mTOR inhibition research continues however with the University of Texas Health Science Center at San Antonio currently investigating the use of rapamycin for inflammation reduction and epigenetic reversal in an active clinical trial (NCT04608448). Subjects aged 65 to 95 will topically apply rapamycin 8% ointment to a forearm daily for 6 months. Both epigenetic and inflammatory markers will be measured. The University of Nottingham is recruiting for another study (NCT05414292) looking at the use of rapamycin and resistance exercise on age related muscle loss. The study aims to recruit 16 healthy male participants over 50 years old who will take a 1mg rapamycin oral tablet daily for 16 weeks along with performing a 14-week unilateral resistance exercise program. Measurements such as changes in muscle mass, strength, power, and function will be recorded.