Drug repositioning has become a matter of intense interest during the past few years. It is an approach to drug development that calls for reinvestigation of candidates that did not succeed in advanced clinical trials (for reasons other than safety) for potential use in other therapeutic indications.
Discussed in this Report:
- Intellectual property coverage for new uses of known drugs
- Tool sets for identifying repositioning opportunities and business strategies
- Applicable legal frameworks and regulatory timelines for repositioned drugs
- Case studies of compound repositioning and approaches taken
- Activities of selected key companies in the drug repositioning business
- Financial aspects and economic potential of drug repositioning
Drug repositioning is also known as drug repurposing, reprofiling, or retasking. In “on-target repurposing,” a drug’s known phar-macological mechanism is applied to a different therapeutic indication than that for which it was initially developed. Even more innovative is “off-target repurposing,” which looks for pharmacological mechanisms that have not yet been described for a known molecule. In either case, having previously failed during clinical development is not a criterion for repositioning; the avenue is equally open to drugs that are or have been marketed.
Drug repurposing can have very different commercial implications. These will depend on where the drug comes from, how much accessible data exist, and how well the repurposer can exploit the new value chain created by a successfully repurposed drug. This will to a large extent depend on what sort of intellectual property can be secured for the drug’s new use, as examined in Chapter 2 of Drug Repositioning: Extracting Value from Prior R&D Investments. The repurposer fights an uphill battle against examiners who will scrutinize the prior art for“obviousness,” i.e., any public facts that can be construed to have anticipated the new medical use of a known drug.
Together with expert knowledge in pharmacology, state-of-the-art genomic, proteomic, animal model, and bioinformatics tech-nologies are employed to identify repurposing opportunities and business strategies. These more technology-oriented aspects are discussed in Chapter 3, followed by an outline of the regulatory environment for repurposing in Chapter 4. Here, we discuss the applicable legal framework and show that while repurposing can remove the initial 1-1.5 years of preclinical and Phase I de-velopment time (the latter only if no new formulation has to be developed and tested), the later stages of the regulatory review process for repurposed drugs are the same as with new chemical entities. Chapter 5 discusses exemplary cases of drug reposi-tioning and the approaches taken, depending on the intended goal.
Drug repurposing has become a new business segment for the life science services industry. Chapter 6 profiles selected key companies that offer platform-based services to identify repurposing opportunities. For the decade ahead to 2020, we predict that cutting-edge repurposing technology will see increasing integration as a standard process of resource utilization, de-risking and acceleration of drug development. In this chapter we also discuss the internal repurposing efforts of Pfizer, Novartis, and Eli Lilly and how these programs tie into their overall development strategies. Drug Repositioning: Extracting Added Value from Prior R&D Investments concludes with a discussion of the financial aspects, considering the benefits of repurposing for larger, smaller, and startup companies.
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- Chapter 1
- INTRODUCTION: A SECOND LIFE FOR DRUGS AND DRUG CANDIDATES
- 1.1. Targets and Agents: Approaching the Limits
- 1.2. Human Physiology as a Network of Interdependencies
- 1.3. Leveraging Drug Repurposing To Turn the Tables on Pipeline Erosion
- 1.4. Finding Another Disease To Treat: On-Target and Off-Target
- Chapter 2
- DRUG REPOSITIONING AND INTELLECTUAL PROPERTY
- 2.1. Considerations Regarding the Patentability Criteria
- 2.2. Searching Prior Art to Assess Repurposing Opportunities
- 2.3. Searching For Intellectual Property Gaps
- 2.4. Data Support: An Indispensable Requirement for Second Use Patenting
- 2.5. Case Study: Developer Actelion Claims Bosentan for Ovarian Cancer
- Chapter 3
- THE STRATEGIC CONCEPT, THE SCIENCE, AND THE TOOLS OF THE THERAPEUTIC SWITCH
- 3.1. What Strategic Considerations Make a Compound a Repositioning Candidate?
- 3.2. Identification of Repurposing Opportunities
- Know the Science
- Know the Resources
- Hypothesis-Driven Approaches
- 3.3. Targeted High-Throughput Screening and Inverse High-Content Screening
- Phenotypic Screening: Parameter-Free High-Content Screening
- Multiplexing Animal Tests
- 3.4. Putting Informatics to Work
- Case Study for Gene Expression: VVP808
- Case Study for Virtual Screening and In Silico Docking: SOSA and Entacapone
- Case Study for Systems Biology: Optimata
- Data Mining and Ligand-Similarity Approaches
- New Opportunities Through Grid Computing?
- 3.5. Repurposing Aided By Drug Reformulation and New Forms of Delivery
- 3.6. Repurposing for Biodefense: A Strategy Outside of the Mainstream
- Chapter 4
- REPOSITIONED DRUGS AND REGULATORY AUTHORITIES
- 4.1. The FDA’s 505(b)(2) New Drug Application
- 4.2. The EMEA “Hybrid Application”
- Chapter 5
- EXAMPLES OF DRUG REPURPOSING
- 5.1. Successfully Repositioned Compounds That Were Never Marketed For Their Original Development Targets or Were Withdrawn From the Market
- Pfizer’s Sildenafil: From Failed Antihypertensive, to Lifestyle Drug, to Orphan Disease
- Thalidomide: A Colossal Tragedy and a New Beginning
- Azidothymidine: A Cancer Drug Candidate Repurposed as an HIV Therapeutic and Vice Versa
- 5.2. Drugs That Were Moderately Successful and Were (Or Are Being) Repurposed
- Galantamine: Transformed Into an Alzheimer’s Drug, With More Perspectives
- Cicletanine: An Antihypertensive for Pulmonary Hypertension
And Diabetes?
- Ropinirole and Pramipexole: Parkinson’s Drugs for Restless Leg Syndrome
- Benzbromarone: A Potentially Problematic Gout Drug Applied To MRSA Infections
- Clioquinol: An Old Antiprotozoal As a Lead Compound for Neuroprotection
- Astemizole: A Problematic Antihistamine with Significant Alternative Perspectives
- 5.3. Successful Primary-Use Drugs in Repurposing Scenarios
- Milnacipran and Duloxetine: Two Antidepressants Now Approved for Fibromyalgia
- Finasteride: From Prostate to Hair Loss
- Imatinib for Diabetes and Rheumatoid Arthritis
- 5.4. Failed, and Failed Again
Perhaps For the Wrong Reasons
- MCI-225: From Psychiatry Drug Candidate, to Gastrointestinal and Urinary Tract Agent
- Chapter 6
- COMPANIES IN THE DRUG REPURPOSING BUSINESS
- 6.1. Business Models Centered On Drug Repurposing: Different From Those for Discovery?
- 6.2. The Small, Drug-Repurposing Specialists
- Sosei Group Corp.
- CombinatoRx, Inc.
- Ore Pharmaceutical Holdings, Inc.
- Biovista, Inc.
- Melior Discovery, Inc.
- Numedicus Ltd.
- Vifor Pharma/Galenica Group
- Aureus Pharma
- Horizon Discovery Ltd.
- Tangent Reprofiling Ltd.
- Anaxomics Biotech SL
- SOM Biotech SL
- SWITCHBIOTECH LLC
- Celentyx Ltd.
- Almac Group Ltd.
- 6.3. “Big Pharma” And Drug Repositioning
- Pfizer
- Novartis
- Eli Lilly
- 6.4. Public Efforts to Facilitate Drug Repurposing
- Chapter 7
- THE ECONOMIC POTENTIAL OF DRUG REPURPOSING
- 7.1. Cost Savings of Repurposing In Discovery and Development
- 7.2. Acceleration of Drug Development: Time Equals Sales
- 7.3. The Benefits of De-Risking
- 7.4. The Repurposing Service Provider’s Perspective
- 7.5. Summary and Outlook
- References
- Company Index with Web Addresses
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