Repurposing of drugs approved for cardiovascular diseases: Opportunity or mirage?

Biochem Pharmacol. 2020 Jul:177:113895. doi: 10.1016/j.bcp.2020.113895. Epub 2020 Mar 4.

Abstract

Drug repurposing is a promising way in drug discovery to identify new therapeutic uses -different from the original medical indication- for existing drugs. It has many advantages over traditional approaches to de novo drug discovery, since it can significantly reduce healthcare costs and development timeline. In this review, we discuss the possible repurposing of drugs approved for cardiovascular diseases, such as β-blockers, angiotensin converting enzyme inhibitors (ACE-Is), angiotensin II receptor blockers (ARBs), statins, aspirin, cardiac glycosides and low-molecular-weight heparins (LMWHs). Indeed, numerous experimental and epidemiological studies have reported promising anti-cancer activities for these drugs. It is worth mentioning, however, that the results of these studies are often controversial and very few data were obtained by controlled prospective clinical trials. Therefore, no final conclusion has yet been reached in this area and no final recommendations can be made. Moreover, β-blockers, ARBs and statins showed promising results in randomised controlled trials (RCTs) where pathological conditions other than cancer were considered. The results obtained have led or may lead to new indications for these drugs. For each drug or class of drugs, the potential molecular mechanisms of action justifying repurposing, results obtained in vitro and in animal models and data from epidemiological and randomized studies are described.

Keywords: Aspirin; Drug repurposing; RAS inhibitors; Statins; β-blockers.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / drug therapy*
  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Animals
  • Aspirin / therapeutic use
  • Bacterial Infections / drug therapy*
  • Cardiac Glycosides / therapeutic use
  • Cardiovascular Diseases / drug therapy*
  • Drug Repositioning / methods*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Marfan Syndrome / drug therapy*
  • Migraine Disorders / drug therapy*
  • Mycoses / drug therapy*
  • Neoplasms / drug therapy*
  • Periodontitis / drug therapy*

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Cardiac Glycosides
  • Heparin, Low-Molecular-Weight
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Aspirin