Challenges for Drug Repurposing in the COVID-19 Pandemic Era

Abstract

The coronavirus disease (COVID-19) pandemic has affected an estimated 16 million persons and caused 0.6 million deaths worldwide by September 2020. The pandemic has led to a rush to repurpose existing drugs, although the underlying evidence base is of variable quality. The improving knowledge of the virology and clinical presentation of COVID-19 is leading to a broadening pool of potential pharmacological targets. The aim of this review is to describe regulatory and pharmacological aspects of drug repurposing and to identify drugs proposed for repurposing in COVID-19 based on registered clinical trials, discussing the evidence to support their use in the treatment of this disease. The challenges of the correct interpretation of existing pre-clinical/clinical evidence as well as the generation of new evidence concerning drug repurposing in COVID-19 will also be discussed.

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

“…The United Nations and countries have made several efforts to reduce prevalence and mortality rates. Many medicines, including repurposed medicines, 179 – 181 have been the subject of clinical trials given the urgent need to reduce current morbidity and mortality rates. Pharmaceutical companies and reputable health institutions have also been working to produce an effective and safe vaccine.…”

Disputes over the production and dissemination of misinformation in the time of COVID-19

“…The frequent suggestion of adding azithromycin for its anti-inflammatory properties [ 9 , 27 ] probably stems from the observation that the use of macrolides in influenza-induced pneumonia has been associated with a faster reduction of inflammatory cytokines [ 28 ]. However it cannot be derived directly from SARS-CoV-2 infections because there is currently no evidence in a clinical setting to support the efficacy of azithromycin treatment in COVID-19 infection, as completed trials are methodologically flawed and underpowered [ 29 ].…”

Functional Fine-Tuning of Metabolic Pathways by the Endocannabinoid System—Implications for Health and Disease

“…The ECS ligands have primarily been used in pain alleviation, which is of great value as pharmacological studies have already been performed enabling their faster repurposing as has been previously suggested in other settings [ 16 , 17 ]. This approach has become especially important in the COVID-19 pandemic era when extreme global negative real-world effects were detected in many aspects of patient care management [ 18 , 19 ] and fast responses from the scientific community are needed. Psychotropic side effects of some ECS-related ligands should not be regarded as an obstacle, as it has been previously shown that exogenous ligands with these properties comprise only a small part of the milieu of potential ECS modifiers [ 20 , 21 ].…”