Real-world drug repurposing (also known as off-label drug use) is the fastest way to deliver benefits to patients affected by COVID-19. Here is a collection of MedInsight’s publications identifying candidates for treatment of COVID-19, focused on safe, widely-available, and affordable treatments with excellent rationale for use.
Delivering Benefits at Speed through Real-World Repurposing of Off-Patent Drugs: The COVID-19 Pandemic as a Case in Point. Abstract
Real-world drug repurposing - the immediate 'off-label' prescribing of drugs to address urgent clinical need - is a widely overlooked opportunity. Off-label prescribing (i.e. for a non-approved indication) is legal in most countries, and tends to shift the burden of liability or cost to physicians and patients, respectively. Nevertheless, health crises may mean that real-world repurposing is the only realistic source of solutions. Optimal real-world repurposing requires a track record of safety, affordability, and access for drug candidates. Although thousands of such drugs are already available, there is no central repository of off-label uses to facilitate immediate identification and selection of potentially useful interventions during public health crises. Using the current COVID-19 pandemic as an example, we provide a glimpse of the extensive literature that supports the rationale behind six generic drugs, in four classes, all of which are affordable, supported by decades of safety data, and target the underlying pathophysiology that makes COVID-19 so deadly. This paper briefly summarizes why cimetidine or famotidine, dipyridamole, fenofibrate or bezafibrate, and sildenafil citrate, are worth considering for patients with COVID-19. Clinical trials to assess efficacy are already underway for famotidine, dipyridamole, and sildenafil, and further trials of all these agents will be important in due course. These examples also reveal the unlimited opportunity to future-proof our healthcare systems by proactively mining, synthesizing, cataloging, and evaluating the off-label treatment opportunities of thousands of safe, well established, and affordable generic drugs.
No Time to Waste: Real-world Repurposing of Generic Drugs as a Multifaceted Strategy against COVID-19 Abstract
Real-world drug repurposing – the immediate ‘off-label’ prescribing of drugs to address urgent clinical need – is an indispensible strategy gaining rapid traction in the current COVID-19 crisis. Although off-label prescribing (i.e. for a non-approved indication) is legal in most countries, it tends to shift the burden of liability or cost to physicians and patients, respectively. Nevertheless, in urgent public health crises it is often the only realistic source of meaningful potential solutions. To be considered for real-world repurposing, drug candidates should ideally have a track record of safety, affordability, and wide accessibility. Although thousands of such drugs are already available, the absence of a central repository of off-label uses presents a barrier to the immediate identification and selection of the safest potentially useful interventions. Using the current COVID-19 pandemic as an example, we provide a glimpse of the extensive literature that supports the rationale behind six generic drugs, in four classes, all of which are affordable, supported by decades of safety data, and pleiotropically target the underlying pathophysiology that makes COVID-19 so dangerous. Having previously fast-tracked this paper to publication in summary form, we now expand on why cimetidine or famotidine, dipyridamole, fenofibrate or bezafibrate, and sildenafil, are worth considering for patients with COVID-19. These examples also reveal the unlimited opportunity to future-proof our health by proactively mining, synthesizing, and cataloging the off-label treatment opportunities of thousands of safe, well established, and affordable generic drugs.
Cepharanthine: A review of the antiviral potential of a Japanese-approved alopecia drug in COVID-19 Abstract
Cepharanthine (CEP) is a naturally occurring alkaloid derived from Stephania cepharantha Hayata and demonstrated to have unique anti-inflammatory, antioxidative, immunomodulating, antiparasitic, and antiviral properties. Its therapeutic potential as an antiviral agent has never been more important in combating COVID-19 caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) virus and resulting so far in over four million cases since its onset. Cepharanthine suppresses nuclear factor-kappa B (NF-κB) activation, lipid peroxidation, nitric oxide (NO) production, cytokine production, and expression of cyclooxygenase; all of which are crucial to viral replication and inflammatory response. Against SARS-CoV-2 and homologous viruses, CEP predominantly inhibits viral entry and replication at low doses; and was recently identified as the most potent coronavirus inhibitor among 2,406 clinically approved drug repurposing candidates in a preclinical model. This review critically analyzes and consolidates available evidence establishing CEP’s potential therapeutic importance as a drug of choice in managing COVID-19 cases.