针对 COVID-19 的药物再利用:潜在疗法的现状

Pravalika Avirineni, Sudheer K. Dundigalla, Satyanarayana S. V. Padi
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摘要

针对2019冠状病毒病(COVID-19)的有效药物的机动临床研究仍在进行中,一种成功且有效的研究药物的环境仍不明朗。药物再利用是一种确定现有药物的新治疗用途的方法,包括已批准的、延迟的、撤回的和正在研究的药物和候选药物。事实上,标准药物发现和开发过程的成本超过10亿美元,而调查预计将持续10-15年。值得注意的是,重新利用现有已批准的药物是一种潜在的、有效的、有利可图的方法,因为它大大减少了开发新药的成本和时间。由于潜在候选药物已确立的安全性、药代动力学和药效学特征,药物再利用可能允许科学家跳过或缩短传统药物发现和开发过程的一些关键步骤。展望未来,可以利用先进的方法进行概念验证试验,从而加快对重新利用药物的临床评估。从COVID-19治疗药物的再利用工作中吸取教训,本综述简要总结了各种潜在药物的现状,这些药物已经被临床评估为再利用平台,并且可以最大限度地提高安全性、有效性和可能的治疗益处,无论是单独使用还是联合使用,以及COVID-19患者的临床结果。
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Drug Repurposing for COVID-19: Current Status of Potential Therapeutics
The maneuver clinical investigation of an effective drug for coronavirus disease 2019 (COVID-19) is still ongoing and the milieu of a successful investigational drug with proven efficacy is still obscure. Drug repurposing is a method to identify new therapeutic uses for existing drugs, which include approved, delayed, withdrawn, and investigational drugs and drug candidates. Indeed, the cost of the standard drug discovery and development process amounts to more than a billion dollars, and the investigations are expected to last 10–15 years. Notably, repurposing existing approved drugs is a potential, effective, and profitable approach as it significantly reduces the cost and time of developing a new drug. Owing to the established safety, pharmacokinetic, and pharmacodynamic profiles of potential drug candidates, drug repurposing may allow scientists to skip or shorten some critical steps of the traditional drug discovery and development process. Prospectively, advanced approaches could be harnessed to conduct proof-of-concept trials that would accelerate the clinical evaluation of repurposed drugs. Drawing lessons from repurposing efforts for COVID-19 therapeutics, the present review briefly summarizes the current status of various potential drugs that have been clinically evaluated for repurposing platforms as well as that could maximize safety, efficacy, and possible therapeutic benefits, both alone or in combination, and clinical outcomes in patients with COVID-19.
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