COVID-19 has exposed the need and opportunity for drug repurposing
By Abby Mynahan
Repurposing FDA-approved drugs, especially generics, is an established method for delivering treatments to patients faster. This has never been more apparent than during the present COVID-19 pandemic.
In the race to find effective COVID-19 treatments, many pharmaceutical companies and academic institutions are investigating repurposed drugs. Around 140 repurposed generic drugs are being tested for COVID-19 in clinical trials (based on trials listed in ReDO Covid19_DB on 6/29/20).
Drugs being tested for COVID-19 have a broad range of mechanisms of action. For example, preclinical studies suggest that the repurposed anti-inflammatory drug colchicine works by reducing blood clots and inflammation, and the repurposed broad-spectrum antiviral medication remdesivir works by inhibiting SARS-CoV-2 virus RNA synthesis.
The generic corticosteroid dexamethasone has emerged as the first treatment with demonstrated efficacy for COVID-19 patients requiring respiratory therapy. Dexamethasone has an established safety profile and is used as an anti-inflammatory to treat diseases like cancer, arthritis, and lupus. Recently, the Randomized Evaluation of COVID-19 Therapy (RECOVERY) Trial found that dexamethasone reduced deaths in hospitalized patients with severe respiratory complications due to COVID-19. Dexamethasone received approval by the U.K. Medicines and Healthcare products Regulatory Agency to treat COVID-19 in June 2020. Although dexamethasone is not approved in the U.S., the FDA added it to a list of drugs for temporary production by outsourcing facilities.
Repurposing low-cost generic drugs to treat COVID-19 offers an opportunity for patients around the world to access effective treatments. Dexamethasone costs only $1 per day of treatment. Many generic drugs, including dexamethasone, are on the WHO Model List of Essential Medicines and are typically available in sufficient quantities in all countries.
At Reboot Rx, we are specifically interested in repurposing generic drugs for cancer - so why are we writing about COVID-19? Patients with certain cancers are nearly three times as likely to die of COVID-19 compared to those without cancer. There is a long history of antiviral drugs being derived from anti-cancer drugs, and vice versa. Interestingly, approximately half of the generic drugs being tested for COVID-19 in clinical trials may also help treat cancer (based on non-cancer generics with documented anti-cancer activity in the ReDO Project). Learning from one disease could end up helping us more effectively treat the other.
