Drug repositioning: current scenario and future prospective for rewriting saga of drug development

Alok Dixit, Ajit K. Mishra, Chandra Veer Singh, Vinay Kumar Gupta, Devesh Pandey
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Abstract

Drug development is a process that demands huge investment of resources and time with only 1 drug candidate successful in reaching market among 10,000 screened taking time duration of 10-15 years and millions of dollars. This high attrition rates discourage investors and researchers. The pharmaceutical industry is shifting its attention away from de novo drug research and towards discovering novel targets and indications for already-approved drugs. In order to accelerate the drug development process with reduced risk of failure and relatively lower costs, pharmaceutical companies have adopted drug repositioning as an alternative. Therefore, a good strategy for drug development would be drug repositioning or drug repurposing, which is to identify, investigate, and exploit new therapeutic uses of already-available, on-market drugs, as well as those that have been withdrawn due to toxicities or that remain on shelves in various stages of development. The outbreak of SARS-COV-19 shows that humanity is constantly vulnerable to epidemics and new microbial attacks and that there is no time to create disease-specific therapies. Consequently, it would seem advantageous to use what is already accessible. Novel therapeutic indications that have previously been approved by the market can reduce investment costs significantly in terms of money, resources, and most importantly, time, as long as they meet PKPD and toxicity standards. Sponsors and pharmaceutical corporations get enthusiastic about additional investments and initiatives related to drug development as a consequence. The upcoming therapeutic revolution, especially with the aid of artificial intelligence, is indicated by the successful applications of several already-available drugs against COVID-19 and the various phases of repurposed drugs against TB, colorectal cancer, Alzheimer’s disease, cervical cancer, and Parkinsonism.
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药物重新定位:改写药物开发传奇的现状与未来展望
药物开发是一个需要投入大量资源和时间的过程,在 10-15 年的时间和数百万美元的资金投入下,1 万个候选药物中只有 1 个能成功进入市场。这种高损耗率令投资者和研究人员望而却步。制药业正在将注意力从新药研究转向为已获批准的药物发现新的靶点和适应症。为了加快药物开发进程,降低失败风险和相对较低的成本,制药公司将药物重新定位作为一种替代方案。因此,药物再定位或药物再利用是药物开发的一个很好的战略,即对已上市的药物、因毒性而撤消的药物或仍处于不同开发阶段的药物进行识别、研究和开发新的治疗用途。SARS-COV-19 的爆发表明,人类随时都有可能受到流行病和新微生物的侵袭,而且已经没有时间来研制针对特定疾病的疗法。因此,利用已有的治疗手段似乎更有优势。只要符合 PKPD 和毒性标准,先前已获市场批准的新治疗适应症就能在资金、资源和最重要的时间方面大大降低投资成本。因此,赞助商和制药公司会热衷于与药物开发相关的额外投资和计划。一些已经上市的抗 COVID-19 药物的成功应用,以及针对肺结核、结直肠癌、老年痴呆症、宫颈癌和帕金森病的各阶段再利用药物的成功应用,都表明了即将到来的治疗革命,尤其是在人工智能的帮助下。
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