The power of drug repurposing

Drug repurposing (also known as repositioning, reprofiling, redirecting, rediscovering, indication expansion or indication shift) involves establishing new medical uses for already known drugs, including approved, discontinued, shelved and experimental drugs.

Currently, repurposed drugs generate around 25% of the annual revenue for the pharmaceutical industry, and public organisations, non-for-profit organisations and a myriad of small drug-repurposing-focused companies have been created in the last 20 years releasing specific programs to promote drug repurposing initiatives. Additionally, the increasing interest in drug repurposing can be also seen in the evolution of related academic publications, with 3.3k new publications about drug repurposing from 2005–2019, and 68% of these retrieved articles/reviews/conference papers/book chapters/ editorials etc corresponding to original material.

Until now, most of the successful and best-known drug repurposing stories (e.g. sildenafil, minoxidil, aspirin, valproic acid) have emerged from serendipitous events in the lab and clinic. For example, Pfizer successfully repurposed Sildenafil (Viagra) from angina to erectile dysfunction (1998) and subsequently to pulmonary arterial hypertension in 2005, while Celgene repositioned Thalidomide (Thalomid) from an anti-nausea medication to treatment of leprosy (1998) and multiple myeloma (2006). Based on another serendipitous finding, zonisamide was approved as an anti-Parkinson’s disease therapy in 2009 in Japan, while was initially used to treat epilepsy.

But now things are about to change since **computational drug repurposing **— or the in silico screening of FDA-approved compounds — is actually a fact, with the emergence of high throughput molecular, clinical and structural biology technologies that combined with the advent of large-scale computational capacity (economically feasible) will create a new opportunity to methodically repurpose existing drugs.

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