The pulmonary route as a way to drug repositioning in COVID-19 therapy

Abstract

Introduction The outbreak of the disease caused by the new coronavirus (COVID-19) has been affecting society’s routine and its patterns of interaction worldwide, in addition to the impact on the global economy. To date, there is still no clinically effective treatment for this comorbidity, and drug repositioning might be a good strategy considering the established clinical safety profile. In this context, since COVID-19 affects the respiratory tract, a promising approach would be the pulmonary drug delivery. Objective Identify repurposing drug candidates for the treatment of COVID-19 based on the data of ongoing clinical trials and in silico studies and also assess their potential to be applied in formulations for pulmonary administration. Method A narrative literature review was conducted between June and July 2020, by extracting the results from Clinical Trials, PubMed, Web of Science and Science Direct databases. Results By crossing the results obtained from diverse sources, 21 common drugs were found, from which only 4 drugs presented studies of pulmonary release formulations, demonstrating the need for greater investment and incentive in this field. Conclusion Even though the lung is a target that facilitates viral infection and replication, formulations for pulmonary delivery of suitable drugs are still lacking for COVID-19 treatment. However, it is indisputable that the pandemic constitutes a concrete demand, with a profound impact on public health, and that, with the appropriate investments, it will give the pharmaceutical industry an opportunity to reinforce the pulmonary delivery field.

Development of a novel rapamycin loaded nano- into micro-formulation for treatment of lung inflammation

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Development of extra-fine particles containing nanosized meloxicam for deep pulmonary delivery: In vitro aerodynamic and cell line measurements

“…An interesting alternative for COVID-19 treatment could be the identification of a suitable repositioned drug to be administered via pulmonary route. The local administration has shown positive results in the treatment of different lung diseases, which may be related to its rapid onset, low metabolic activity, and reduction of adverse effects (Sarcinelli et al, 2021). As previously mentioned, direct lung delivery could be the barely most efficient way to apply the poorly-water soluble MX.…”

Investigation of Physico-Chemical Stability and Aerodynamic Properties of Novel “Nano-in-Micro” Structured Dry Powder Inhaler System

“…In human therapy, osteoarthritis, and arthritis are currently the principal indications of MX [ 25 ]. However, COX-2 inhibitors could be used to treat pulmonary inflammation, such as SARS-CoV-2 infection, which induces the COX-2 expression and may help to control the lung inflammation and damage seen in COVID-19 patients [ 26 , 27 , 28 ]. It could be advantageous to improve and maintain the condition of patients with cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), and non-small-cell lung cancer (NSCLC) [ 29 , 30 , 31 , 32 ].…”