Purpose: Chronic pain is a debilitating condition faced among the geriatric population, contributing to reduced mobility, impaired daily function, and increased dependence on healthcare services. This review explores the current landscape of chronic pain in the elderly, providing a comprehensive overview of treatment options, with the goal of exploring more effective, individualized care. Patients and Methods: This narrative review draws on a range of studies and clinical publications accessible through the National Center for Biotechnology Information (NCBI) database. The literature reviewed includes research on the underlying mechanisms, diagnostic challenges, and treatment strategies for chronic pain in older adults. Clinical relevance and practical approaches were explored, where risks and benefits of pharmacologic, non-pharmacologic, and interventional therapies were explored. Results: Chronic pain in the elderly is often undertreated, likely due to unaccounted comorbidities and age-related changes in drug metabolism. While acetaminophen remains the recommended first-line agent, the use of NSAIDs and opioids in this population carries significant risks and demands careful consideration. Adjuvant medications such as SNRIs and gabapentinoids offer additional options for neuropathic pain, but may require dose adjustments or close adverse effect monitoring. Non-pharmacologic interventions—such as physical therapy and cognitive behavioral therapy— often are underutilized despite a strong safety profile and evidence of benefit. In cases refractory to conservative measures, interventional procedures including epidural steroid injections, radiofrequency ablation, and spinal cord stimulation may offer meaningful relief for select patients. Conclusion: Managing chronic pain in older adults requires a thoughtful, individualized approach that balances effectiveness with safety. As the population ages, there is a growing need for more inclusive research, better integration of non-drug therapies, and greater access to interdisciplinary care. Tailoring treatment to individual goals can help improve outcomes and preserve independence and function in this vulnerable group.

1. Human immunodeficiency virus (HIV) is a wide-reaching pathogen, with over 40.8 million individuals living with this disease throughout the world [1]. There are two major serotypes of HIV, HIV-1,...

Epitalon is a synthetic tetrapeptide derived from the amino acid composition of Epithalamin, a polypeptide extract derived from the bovine pineal gland. Current preclinical evidence suggests that Epitalon may activate telomerase by upregulating human telomerase reverse transcriptase (hTERT). In aged primates, Epitalon has also been associated with restoring evening melatonin synthesis and circadian cortisol rhythms. It has also been shown to enhance endogenous antioxidant defenses, including the activity of superoxide dismutase (SOD) and glutathione peroxidase. These mechanisms may be relevant to the future of regenerative medicine, as dysregulation of these pathways has been independently implicated in common musculoskeletal conditions, including osteoarthritis, disc degeneration, osteoporosis, and impaired tissue repair. In female mice, although Epitalon did not affect mean lifespan, the maximum lifespan increased by 12.3%. Evidence suggests that it may preserve retinal integrity in hereditary retinitis pigmentosa without reported adverse effects.[1] No human randomized controlled trials, pharmacokinetic studies, or registered trials of Epitalon have been reported at the time of this publication. The related polypeptide preparation Epithalamin, however, does have limited human studies in elderly patients. Epithalamin treatment was associated with a reduced incidence of cardiovascular and musculoskeletal disease, as well as decreased mortality over 6-8 years of follow-up.[2] This review synthesizes the available evidence on Epitalon in the context of regenerative medicine.

Epitalon (Ala-Glu-Asp-Gly) is a synthetic tetrapeptide developed from the amino-acid composition of epithalamin, a chemically distinct pineal-derived polypeptide preparation. This narrative review evaluates the mechanistic, preclinical, and human evidence for synthetic epitalon in the context of regenerative and longevity medicine, while considering epithalamin studies separately as historical context. PubMed and Google Scholar were searched through 22 September 2026, with primary experimental and clinical studies prioritized and evidence appraised by study design, model, sample size, intervention, outcomes, safety reporting, and independent replication. Epitalon has been reported to modulate telomere-maintenance pathways, circadian and neuroendocrine function, oxidative stress, and cellular aging markers. Preclinical studies suggest biological activity, but direct evidence in musculoskeletal disease models is lacking. Human evidence is limited to small physiological or biomarker studies and an older controlled study in retinitis pigmentosa; no adequately powered randomized trial has established therapeutic efficacy. Pharmacokinetic, dose-ranging, and long-term safety data remain inadequate, while oncologic, immunogenicity, product-quality, and regulatory uncertainties following a 2026 FDA advisory review remain unresolved. Epitalon is therefore biologically active but clinically unproven, and further standardized pharmacologic, safety, and disease-specific studies are needed before clinical translation.

Epitalon is a synthetic tetrapeptide (Ala-Glu-Asp-Gly) developed from the amino-acid composition of epithalamin, a pineal-derived polypeptide preparation. Although historically related, the two preparations are chemically distinct and their evidence should not be considered interchangeable. This narrative review examines the mechanistic, preclinical, and human evidence for epitalon, with epithalamin studies considered separately as historical context. The strongest mechanistic evidence for epitalon involves telomerase activation and telomere elongation in human cell lines. These findings were independently replicated in 2025, with telomere extension occurring through hTERT/telomerase upregulation in normal cells and alternative lengthening of telomeres in cancer cell lines.[1] Preclinical studies have also reported age-dependent neuroendocrine effects, antioxidant-associated activity, and tissue-protective effects. In female mice, epitalon did not increase mean lifespan but increased maximum lifespan by 12.3%.[2] Human epitalon evidence remains limited to small physiological or biomarker studies and an older report in retinitis pigmentosa; no adequately powered randomized trial has established therapeutic efficacy.[1,3,4] Historical epithalamin studies have reported neuroendocrine, antioxidant, cardiovascular, and longevity-associated outcomes, but these findings cannot be directly extrapolated to epitalon. Human pharmacokinetic, dose-ranging, and dedicated prospective safety studies remain unavailable, while telomere-maintenance effects raise theoretical but unresolved questions regarding long-term oncologic safety. FDA reviewed epitalon free base and acetate through the 2026 PCAC compounding process, which does not constitute therapeutic approval. [5] Overall, epitalon demonstrates biologically relevant activity but remains clinically unproven. Independent replication, pharmaceutical characterization, pharmacokinetic and safety studies, disease-specific preclinical models, and appropriately designed human trials are needed before its role in regenerative or longevity medicine can be established.