Is the cure for COVID-19 already out there?
One of the consistent messages we have heard from the scientific community during the historic outbreak of COVID-19 is to have patience.
Normally, it takes years to develop a drug, they say. In this case, even with the resources of the entire world seemingly pushing in the same direction, it will take at least 12-18 months for a coronavirus cure. That comes from World Health Organization director Tedros Adhanom Ghebreyesus, who grimly explained that “Viruses can have more powerful consequences than any terrorist action,” at a meeting in Geneva held as the coronavirus outbreak was in its infancy.
But what if there were already a drug out there that could tackle COVID-19?
In fact, there very well may be. The phenomenon is called drug “repurposing” or “repositioning” and it’s more common than you think.
“It’s estimated that about 90 percent of FDA-approved compounds can be used for more than one purpose,” says Michael Rosenblum, Ph.D., professor of Experimental Therapeutics. “We can teach old drugs new tricks by matching them to the molecular pathways of other diseases.”
You already know some famous examples of drug repurposing. Minoxidil, commercially known as Rogaine, was originally a treatment for high blood pressure. Viagra was intended for cardiovascular disease.
But not all drug repurposements work out. Thalidomide was originally posited as a sedative because of effects that mirrored barbituates. Then, it was repositioned to treat morning sickness during pregnancy, to disastrous and historic effect. But few know that Thalidomide is currently on the World Health Organization’s List of Essential Medicines, and is now being put forth to treat a skin conditions and cancers.
Professor Nevan Krogan, a Canadian molecular biologist who is a professor in the Department of Cellular and Molecular Pharmacology at the University of California San Francisco, says not only is drug repositioning a viable method, it is absolutely one we should be pursuing in the time between now and when we have a purpose-built cure for COVID-19.
“Using pre-approved drugs is the best strategy in the short term to help people as others, develop, maybe more sophisticated targeted approaches say with a vaccine or with drugs that target the virus but that could take months if not years,” Krogan told Bloomberg Monday.
But that’s not to say it will be easy and Krogan explained the complications facing researchers racing for a treatment.
“What we have noticed is that this virus, in a very interesting way, is coming in, and essentially hijacking all the major biological processes in the cell in a very fascinating way,” he explained. “It’s getting its fingers in pretty much all the major machinery in ourselves. So the virus needs our cells and our genes and proteins in order to live and replicate and infect our cells. So the question is what are those proteins? We generated this map…this blueprint, where we’re essentially looking for all the human proteins connected to other proteins. We identified 332 of these human proteins through this study, and predicted drugs or compounds that would come and bind to and inhibit these human proteins. Of the sixty-nine that we predicted to bind to one of these 332 proteins, 27 are FDA approved drugs, and the rest are in clinical trials are being looked at pre-clinically.”
Krogan said that while some drugs can take eight to ten years to pass through toxicity trials, success in this way can produce a treatment that can be deployed almost immediately.
“The logic here is if we do get a hit on one of these drugs we can go and look at one of them in more detail, and then see what other drugs or compounds are similar to it so we can expand our search space based on this initial screen which will give us, hopefully, a higher likelihood of success,” he added.
So why isn’t drug repurposing done even more often? Professor Krogan says it comes down to money.
A lot of times that’s not done, this kind of drug repurposing,” he said. “One of the reasons is financially related. Companies have patents for specific compounds or drugs. And if another company finds that “Oh this drug can be used for another disease,” then the original company will get all the financial benefit from that. People don’t look at it in that way that much. But of course now everybody just wants to solve this particular problem.”
Below: Repurposed Drugs Offer Shortest Path to Coronavirus Treatment