Search

DrugRepurposing Online is a database of well-curated literature examples of drug repurposing, structured by reference to compounds and indications, via a generalisation layer (within specific datasets) of mechanism. References are categorised by level of relevance to human application to assist users in prioritising repurposing hypotheses. Users can search freely between any two of the three categories in either direction; results can then be extended to the third category. The concatenation of two (or more) direct relationships to create an indirect, hypothetical new repurposing relationship is intended to offer novel and non-obvious opportunities that can be both patented and efficiently developed. A natural language processing (NLP) powered search capability extends the opportunities from the hand-curated foundation to identify further opportunities., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: A hallmark of acute respiratory distress syndrome (ARDS) is hypoxaemic respiratory failure due to pulmonary vascular hyperpermeability. The tyrosine kinase inhibitor imatinib reversed pulmonary capillary leak in preclinical studies and improved clinical outcomes in hospitalized COVID-19 patients. We investigated the effect of intravenous (IV) imatinib on pulmonary edema in COVID-19 ARDS., Methods: This was a multicenter, randomized, double-blind, placebo-controlled trial. Invasively ventilated patients with moderate-to-severe COVID-19 ARDS were randomized to 200 mg IV imatinib or placebo twice daily for a maximum of seven days. The primary outcome was the change in extravascular lung water index (∆EVLWi) between days 1 and 4. Secondary outcomes included safety, duration of invasive ventilation, ventilator-free days (VFD) and 28-day mortality. Posthoc analyses were performed in previously identified biological subphenotypes., Results: 66 patients were randomized to imatinib (n = 33) or placebo (n = 33). There was no difference in ∆EVLWi between the groups (0.19 ml/kg, 95% CI - 3.16 to 2.77, p = 0.89). Imatinib treatment did not affect duration of invasive ventilation (p = 0.29), VFD (p = 0.29) or 28-day mortality (p = 0.79). IV imatinib was well-tolerated and appeared safe. In a subgroup of patients characterized by high IL-6, TNFR1 and SP-D levels (n = 20), imatinib significantly decreased EVLWi per treatment day (- 1.17 ml/kg, 95% CI - 1.87 to - 0.44)., Conclusions: IV imatinib did not reduce pulmonary edema or improve clinical outcomes in invasively ventilated COVID-19 patients. While this trial does not support the use of imatinib in the general COVID-19 ARDS population, imatinib reduced pulmonary edema in a subgroup of patients, underscoring the potential value of predictive enrichment in ARDS trials. Trial registration NCT04794088 , registered 11 March 2021. European Clinical Trials Database (EudraCT number: 2020-005447-23)., (© 2023. The Author(s).)

Given the high attrition rates, substantial costs and slow pace of new drug discovery and development, repurposing of 'old' drugs to treat both common and rare diseases is increasingly becoming an attractive proposition because it involves the use of de-risked compounds, with potentially lower overall development costs and shorter development timelines. Various data-driven and experimental approaches have been suggested for the identification of repurposable drug candidates; however, there are also major technological and regulatory challenges that need to be addressed. In this Review, we present approaches used for drug repurposing (also known as drug repositioning), discuss the challenges faced by the repurposing community and recommend innovative ways by which these challenges could be addressed to help realize the full potential of drug repurposing.

Mutations in the X-linked cyclin-dependent kinase-like 5 (CDKL5) gene cause a complex neurological disorder, characterized by infantile seizures, impairment of cognitive and motor skills and autistic features. Loss of Cdkl5 in mice affects dendritic spine maturation and dynamics but the underlying molecular mechanisms are still far from fully understood. Here we show that Cdkl5 deficiency in primary hippocampal neurons leads to deranged expression of the alpha-amino-3-hydroxy-5-methyl-4-iso-xazole propionic acid receptors (AMPA-R). In particular, a dramatic reduction of expression of the GluA2 subunit occurs concomitantly with its hyper-phosphorylation on Serine 880 and increased ubiquitination. Consequently, Cdkl5 silencing skews the composition of membrane-inserted AMPA-Rs towards the GluA2-lacking calcium-permeable form. Such derangement is likely to contribute, at least in part, to the altered synaptic functions and cognitive impairment linked to loss of Cdkl5. Importantly, we find that tianeptine, a cognitive enhancer and antidepressant drug, known to recruit and stabilise AMPA-Rs at the synaptic sites, can normalise the expression of membrane inserted AMPA-Rs as well as the number of PSD-95 clusters, suggesting its therapeutic potential for patients with mutations in CDKL5.

Respiratory depression remains an important clinical problem that limits the use of opiate analgesia. Activation of AMPA glutamate receptors has been shown to reverse fentanyl-induced respiratory changes. Here, we explored whether tianeptine, a drug known for its ability to phosphorylate AMPA receptors, can be used to prevent opiate-induced respiratory depression. A model of respiratory depression in conscious rats was produced by administration of morphine (10mg/kg, i.p.). Rats were pre-treated with test compounds or control solutions 5min prior to administration of morphine. Respiratory activity was measured using whole-body plethysmography. In conscious animals, tianeptine (2 and 10mg/kg, ip) and DP-201 (2-(4-((3-chloro-6-methyl-5,5-dioxido-6,11-dihydrodibenzo[c,f][1,2] thiazepin-11-yl)amino)butoxy)acetic acid; tianeptine analogue; 2mg/kg, ip) triggered significant (~30%) increases in baseline respiratory activity and prevented morphine-induced respiratory depression. These effects were similar to those produced by an ampakine CX-546 (15mg/kg, ip). The antinociceptive effect of morphine (hot plate test) was unaffected by tianeptine pre-treatment. In conclusion, the results of the experiments conducted in conscious rats demonstrate that systemic administration of tianeptine increases respiratory output and prevents morphine-induced respiratory depression without interfering with the antinociceptive effect of opiates., (Copyright © 2015 Elsevier B.V. All rights reserved.)

There are nearly 2000 patent and peer-reviewed literature-based examples of drug repurposing to be found at http://www.drugrepurposing.info/; yet there has recently been a spate of experimental techniques used to predict new drug repurposing opportunities. This review questions whether these new methods - from computerised modelling of drug-target interactions to retrospective analysis of clinical experience - merely add testable hypotheses without addressing their inherent validity, or whether they also partially validate the new uses so that the predictions are more likely to be successfully developed. In addition, ontological methods take existing information and link two known facts to create an unknown association. These can both enhance other methods of repurposing and provide patented, commercial products, including several case historical examples., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The increasing realization that many existing drugs do indeed provide opportunities for additional therapeutic indications suggests we should not only be alert for this potential among marketed drugs but also within the pool of developmental drugs, of which (owing to attrition) there are many more examples in existence. We present examples of drug repurposing by retrospective clinical trial analysis and suggest that this strategy presents a promising way of rescuing failed developmental candidates. We contend that the commercial barriers to successful drug rescue are less problematic than for drug repurposing. We indicate practical means for mining data from past clinical trials, either for new indications or for specific patient groups., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Pharmaceutical R&D is notoriously risky, lengthy and costly; moreover, it does not always produce products of blockbuster status. The conventional route of fully discovering, developing and marketing a new chemical entity is followed by the large pharmaceutical companies, whereas other organizations in the pharmaceutical sector--such as generic or specialty companies and biotechnology companies--only operate over portions of the full R&D process. Here, we compare the ten-year financial performance of these three subsectors through their price/earnings ratios and their return on capital metrics to understand which of these strategic alternatives offered the best return to investors., (2009 Elsevier Ltd. All rights reserved.)

New chemical entity discovery and development is a long, expensive and risky way of producing new therapeutics. An alternative approach, namely finding new uses for existing drugs, offers substantial advantages in terms of cost, time and risk, and represents a highly attractive strategy to drug discovery. Patents protecting the new use may also be obtained. There are multiple different classes of such R and D programs, depending on whether the original development is still protected by composition of matter patents, and whether the compound was ever fully developed/marketed for its original indication. There are also shortened R and D programs for new uses for stereoisomers and metabolites of existing drugs. Case histories in all areas are presented.

The availability of widespread contractual services led to the birth of the virtual company in the 1990s. As the concept has matured, and the biotechnology sector diversified, interchange of intellectual property in the form of collaborative and license arrangements opens up still further the opportunities for outsourced forms of pharmaceutical R&D.

V11294 is a new cyclic nucleotide phosphodiesterase type 4 (PDE4) inhibitor of the rolipram class. In this report we present the pharmacological profile of V11294. V11294 inhibited PDE4 isolated from human lung with IC(50) 405 nM, compared to 3700 nM for rolipram. In contrast, V11294 inhibition of human PDE3 and PDE5 occurred only at concentrations greater than 100,000 nM. Like rolipram, V11294 inhibited PDE4D more potently than other PDE4 subtypes. V11294, when incubated with human anticoagulated whole blood in vitro, or administered to mice, caused increased cAMP concentration, consistent with inhibition of PDE4. V11294 inhibited lectin-induced proliferation and lipopolysaccharide-induced TNFalpha synthesis by human adherent monocytes in vitro and inhibited lipopolysaccharide-induced TNFalpha synthesis in mice. V11294 caused relaxation of guinea pig isolated trachea and inhibited allergen-induced bronchoconstriction and eosinophilia in guinea pigs at doses of 1 and 3 mg/kg, p.o. In ferrets, V11294 was not emetogenic at doses up to 30 mg/kg, p.o., despite plasma concentration reaching 10-fold the IC(50) for PDE4. In contrast, rolipram induced severe retching and vomiting at 10 mg/kg, p.o. In conclusion, V11294 is an orally active PDE4 inhibitor that exhibits antiinflammatory activity in vitro, and in vivo at doses that are not emetogenic., (Copyright 2003 Elsevier Science Ltd.)

The most recent meeting organized by the Society for Medicines Research, entitled Improving Medicines Through Drug Delivery, was held at the National Heart and Lung Institute in London on July 5, 2001. Drug delivery is increasingly becoming a central technology in the research and development of better medicines. This is so for at least three reasons. First, new drugs are being derived from complex biological molecules that are not readily amenable to oral delivery. Second, improved medicine is recognized as requiring better dosing regimens for the patient. Both compliance and preference are improved by reduced dosing frequency, and it is rare for new products to require three-times-daily administration. Lastly, drug delivery technology has come a long way in the past 20 years, beyond controlled-release pharmaceuticals to polymer conjugates and dry powder-inhaled proteins., ((c) 2001 Prous Science. All rights reserved.)