Wesley Greenblatt, Harvard University, Boston Children's Hospital, and Massachusetts Institute of Technology, Boston, Massachusetts.
Charu Gupta, University of California Los Angeles, Los Angeles, California.
Health Aff (Millwood). 2023 Mar;42(3):424-432. doi: 10.1377/hlthaff.2022.01083.
The COVID-19 pandemic created a large, sudden unmet public health need for rapid access to safe and effective treatments. Against this backdrop, policy makers and researchers have looked to drug repurposing-using a drug previously approved for one indication to target a new indication-as a means to accelerate the identification and development of COVID-19 treatments. Using detailed data on US clinical trials initiated during the pandemic, we examined the trajectory and sources of drug repurposing initiatives for COVID-19. We found a rapid increase in repurposing efforts at the start of the pandemic, followed by a transition to greater de novo drug development. The drugs tested for repurposing treat a wide range of indications but were typically initially approved for other infectious diseases. Finally, we documented substantial variation by trial sponsor (academic, industry, or government) and generic status: Industry sponsorship for repurposing occurred much less frequently for drugs with generic competitors already on the market. Our findings inform drug repurposing policy for both future emerging diseases and drug development in general.
新冠疫情大流行导致公众对快速获得安全有效的治疗方法的需求巨大且突然，而这一背景下，政策制定者和研究人员将药物再利用——即将先前批准用于一种适应症的药物用于新的适应症——作为加速识别和开发新冠治疗方法的一种手段。我们利用大流行期间在美国启动的临床试验的详细数据，研究了新冠药物再利用计划的轨迹和来源。我们发现，疫情开始时药物再利用的努力迅速增加，随后转向更多的全新药物开发。用于再利用测试的药物治疗范围广泛，但通常最初是为其他传染病批准的。最后，我们记录了试验赞助商（学术、行业或政府）和通用状态的重大差异：对于已经在市场上有通用竞争对手的药物，行业再利用赞助的情况要少得多。我们的发现为未来的新发疾病和一般药物开发的药物再利用政策提供了信息。
