Will the COVID-19 Pandemic Finally Fuel Drug Repurposing Efforts

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has turned the health care world upside down. Research and medical institutions have delved deeply into health care arsenals to identify some unlikely heroes that have helped to treat a disease that seemingly evolves with each passing day. In a controlled, open-label trial of hospitalized COVID-19 patients, the Randomized Evaluation of COVID-19 Therapy (RECOVERY) Collaborative Group found that the use of dexamethasone, a cheap generic drug commonly used to treat a variety of inflammatory conditions, resulted in lower 28-day mortality in COVID-19 patients receiving respiratory support. This is not the only incidence of older generic drugs being repurposed to combat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus; however, it is one of the more successful stories. The urgency to find effectiveness in older drugs has come with some serious pitfalls. Chloroquine phosphate and hydroxychloroquine sulfate, 2 drugs originally used for malaria, were broadcast at the beginning of the pandemic as possible “cures” for the new virus. Ensuing demand for these products threatened to interrupt chronic therapy among patients using the drugs for evidence-based indications such as lupus, only for the Food and Drug Administration (FDA) to revoke their Emergency Use Authorization (EUA) for COVID-19 because of reports of ineffectiveness and serious cardiac adverse events.