Repurposing drugs for the management of COVID-19

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 represents a serious health issue worldwide, with more than 61 million cases and more than 1.4 million deaths since the beginning of the epidemic near the end of 2019. The scientific community strongly responded to this emergency situation with massive research efforts, mostly focused on diagnosis and clinical investigation of therapeutic solutions. In this scenario, drug repurposing played a crucial role in accelerating advanced clinical testing and shortening the time to access the regulatory review.

Areas covered: This review covers the main and most successful drug repurposing approaches from a design, clinical, and regulatory standpoint. Available patents on repurposed drugs are also discussed.

Expert opinion: Drug repurposing proved highly successful in response to the current pandemic, with remdesivir becoming the first specific antiviral drug approved for the treatment of COVID-19. In parallel, a number of drugs such as corticosteroids and low molecular weight heparin (LMWH) are used to treat hospitalized COVID-19 patients, while clinical testing of additional therapeutic options is ongoing. It is reasonably expected that these research efforts will deliver optimized and specific therapeutic tools that will increase the preparedness of health systems to possible future epidemics.

KEYWORDS:

• COVID-19
• drug repurposing
• remdesivir
• antiviral drugs
• coronavirus
• SARS-CoV-2

Article highlights

• COVID-19 triggered massive research efforts in the search of effective drugs, diagnostic tools, and vaccines.

• Drug repurposing represented a powerful approach to accelerate the discovery of COVID-19 treatment options.

• Several clinical trials on COVID-19 management have been launched, most of which focused on repurposed drugs.

• Currently, COVID-19 is managed with antiviral drugs, or adjunctive drugs that treat the main symptoms.

• Remdesivir is the first specific antiviral agent against SARS-CoV-2 that received approval from regulatory authorities.

• Remdesivir became a successful example of drug repurposing, being approved for COVID-19 management in less than one year from the beginning of the pandemic.

This box summarizes key points contained in the article.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.