Drug repositioning
This article has multiple issues. Please help improve it or discuss these issues on the talk page. (Learn how and when to remove these template messages)
|
Drug repositioning (also called drug repurposing) involves the investigation of existing drugs for new therapeutic purposes.[1][2][3]
Repurposing achievements
Repurposing generics can have groundbreaking effects for patients: 35% of 'transformative' drugs approved by the US FDA are repurposed products.[4] Repurposing is especially relevant for rare or neglected diseases.[4]
A number of successes have been achieved, the foremost including sildenafil (Viagra) for erectile dysfunction and pulmonary hypertension and thalidomide for leprosy and multiple myeloma.[3][5] Clinical trials have been performed on posaconazole and ravuconazole for Chagas disease.[6]
Other antifungal agents clotrimazole and ketoconazole have been investigated for anti-trypanosome therapy.[7] Successful repositioning of antimicrobials has led to the discovery of broad-spectrum therapeutics, which are effective against multiple infection types.[8]
Strategy
Drug repositioning is a "universal strategy" for neglected diseases due to 1) reduced number of required clinical trial steps could reduce the time and costs for the medicine to reach market, 2) existing pharmaceutical supply chains could facilitate "formulation and distribution" of the drug, 3) known possibility of combining with other drugs could allow more effective treatment,[1] 4) the repositioning could facilitate the discovery of "new mechanisms of action for old drugs and new classes of medicines",[1][9] 5) the removal of “activation barriers” of early research stages can enable the project to advance rapidly into disease-oriented research.[10]
Often considered as a serendipitous approach, where repurposable drugs are discovered by chance, drug repurposing has heavily benefited from advances in human
Computational drug repurposing is the in silico screening of approved drugs for use against new indications. It can use molecular, clinical or biophysical data.[15] Electronic health records and real-world evidence gained popularity in drug repurposing, for instance for COVID 19.[16] Computational drug repurposing is expected to reduce drug development costs and time.[17]
Drug repositioning evidence level | Quality of scientific evidence |
---|---|
0 | No evidence; includes in silico predictions without confirmation |
1 | In vitro studies with limited value for predicting in vivo/human situation |
2 | Animal studies with hypothetical relevance in humans |
3 | Incomplete studies in humans at the appropriate dose e.g. proof of concept; few cases from medical records; some clinical effects observed |
4 | Well-documented clinical end points observed for repositioned drug at doses within safety limits |
Challenges
According to a 2022 systematic review, inadequate resources (financial and subject matter expertise), barriers to accessing shelved compounds and their trial data, and the lack of traditional IP protections for repurposed compounds are the key barriers to drug repurposing.
Drug repositioning present other challenges. First, the
Drug repurposing in psychiatry
Drug repurposing is considered a rapid, cost-effective, and reduced-risk strategy for the development of new treatment options also for psychiatric disorders.[1][21]
Bipolar disorder
In
See also
References
- ^ S2CID 237485915.
- S2CID 25267555.
- ^ S2CID 205475073.
- ^ PMID 25646109.
- PMID 24872991.
- PMID 37576826.
- S2CID 73728129.Section 2.2.2. "Repositioning of Drugs"
- ^ PMID 34870144.
- PMID 32256547.
- ^ PMID 22368688.
- PMID 31982325.
- PMID 31830040.
- PMID 32151704.
- PMID 25843679.
- PMID 31326236.
- PMID 35701544.
- PMID 32055582.
- PMID 35906687.
- S2CID 237717052.
- PMID 29880920.
- PMID 29352538.
Further reading
- Nabirotchkin S, Peluffo AE, Rinaudo P, Yu J, Hajj R, Cohen D (April 2020). "Next-generation drug repurposing using human genetics and network biology". Current Opinion in Pharmacology. 51: 78–92. PMID 31982325.
- Chong CR, Sullivan DJ (August 2007). "New uses for old drugs". Nature. 448 (7154): 645–646. S2CID 154688.
- Kumar R, Harilal S, Gupta SV, Jose J, Thomas Parambi DG, Uddin MS, et al. (November 2019). "Exploring the new horizons of drug repurposing: A vital tool for turning hard work into smart work". European Journal of Medicinal Chemistry. 182: 111602. PMID 31421629.
- Tartaglia LA (November 2006). "Complementary new approaches enable repositioning of failed drug candidates". Expert Opinion on Investigational Drugs. 15 (11): 1295–1298. S2CID 44742830.
- Aronson JK (November 2007). "Old drugs--new uses". British Journal of Clinical Pharmacology. 64 (5): 563–565. PMID 17935601.
- Pritchard JE, O'Mara TA, Glubb DM (December 2017). "Enhancing the Promise of Drug Repositioning through Genetics". Frontiers in Pharmacology. 8: 896. PMID 29270124.