Repurposed Medicines for Viruses With Epidemic or Pandemic Potential: A Horizon Scan

Area of Science:

• Virology
• Drug Discovery
• Public Health

Background:

• Emerging viral threats like Ebola, influenza, and SARS-CoV-2 necessitate rapid therapeutic development.
• Developing novel antiviral drugs is lengthy and costly.
• Repurposing existing medicines provides a quicker, more economical approach to expand treatment options during health emergencies.

Purpose of the Study:

• To map current research on repurposed medicines for epidemic and pandemic viral pathogens.
• To identify antiviral drugs in development for viruses including influenza and SARS-CoV-2.

Main Methods:

• A horizon scanning approach was used, combining Embase database searches with ClinicalTrials.gov.
• Searches focused on UK- or EU-licensed medicines investigated for antiviral use, excluding vaccines and already-approved treatments.
• 196 repurposed technologies were identified in literature, with 58 in active clinical development.

Main Results:

• Active clinical development was concentrated on influenza and SARS-CoV-2.
• Twenty-nine repurposed technologies for SARS-CoV-2 and two for influenza reached Phase III.
• Other viruses showed repurposed candidates only in preclinical or exploratory stages.
• Common classes included direct-acting antivirals, immunomodulators, and anti-inflammatories.

Conclusions:

• Drug repurposing is a promising strategy for rapid therapeutic deployment against viral threats.
• Further preclinical validation, pharmacokinetic assessment, and mechanistic studies are crucial before clinical application.
• Current clinical trial activity for repurposed antivirals is limited to influenza and SARS-CoV-2.