The PEARL trial — published in full results in 2025 — was the most rigorous human study of low-dose rapamycin for aging to date. It was a decentralized, single-center, prospective, double-blind, placebo-controlled trial assessing rapamycin in healthy individuals aged 50 to 85 years over one year, registered as NCT04488601 on ClinicalTrials.gov.
What did it find? The honest summary from independent analysis: PEARL showed that low-dose rapamycin is likely safe over a year in healthy adults, with some secondary signals of benefit — particularly in women — but it did not prove that rapamycin extends healthspan or lifespan in humans.
No published human trial has demonstrated lifespan extension with rapamycin. No trial has used all-cause mortality as a primary endpoint in a healthy aging population. That is the central gap between the animal evidence and the human evidence….The off-label prescribing of rapamycin for longevity in healthy adults — which is occurring at scale in longevity medicine practices — is ahead of the evidence.
