Antiprotozoal medications associated with increased longevity and reduced morbidity in two national cohorts

Abstract

To identify medications with the potential to increase human lifespan, we conducted a systematic screening of electronic health records from a national health organization, comparing medications consumed over the preceding decade by individuals over 60 who outlived the average life expectancy with those consumed by matched individuals who died before reaching it. This screen identified two antiprotozoal agents, atovaquone-proguanil and mefloquine, as strongly associated with increased longevity (odds ratios for 10-year mortality: 0.43 and 0.32; FDR = 0.0002 and 0.0001, respectively). We validated these associations in the U.S.-based TriNetX federated network, confirming that these two antiprotozoals, along with nirmatrelvir-ritonavir--a medication used to prevent severe COVID-19 outcomes and possessing antiprotozoal properties--were associated with significantly reduced mortality and a lower incidence of major age-related conditions, including diabetes mellitus, cardiovascular and cerebrovascular diseases, renal insufficiency, dementia, pulmonary disease, liver disease, and malignancies. Across both populations, antiprotozoal exposure was also associated with increased risks of specific adverse outcomes, notably hearing loss, Sjogrens syndrome, and lichen planus. The consistent observation of both benefits and risks across independent populations supports the biological plausibility of these effects and argues against confounding by indication or underdiagnosis. Taken together, these findings suggest that elimination of protozoal parasites--notably Toxoplasma gondii-- may significantly reduce human age-related morbidity and mortality while increasing the risk of specific auditory, ophthalmic, and dermatologic complications. These results offer promising new avenues to extend human lifespan and promote healthy aging through targeted antimicrobial interventions.