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Drug Repositioning: Playing Dirty to Kill Pain

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Abstract

The number of approved new molecular entity drugs has been decreasing as the pharmaceutical company investment in research and development is increasing. As we face this painful crisis, called an innovation gap, there is increasing awareness that development of new uses of existing drugs may be a powerful tool to help overcome this obstacle because it takes too long, costs too much and can be risky to release drugs developed de novo. Consequently, drug repositioning is emerging in different therapeutic areas, including the pain research area. Worldwide, pain is the main reason for seeking healthcare, and pain relief represents an unmet global clinical need. Therefore, development of analgesics with better efficacy, safety and cost effectiveness is of paramount importance. Despite the remarkable advancement in research on cellular and molecular mechanisms underlying pain pathophysiology over the past three decades, target-based therapeutic opportunities have not been pursued to the same extent. Phenotypic screening remains a more powerful tool for drug development than target-based screening so far. It sounds somewhat heretical, but some multi-action drugs, rather than very selective ones, have been developed intentionally. In the present review, we first critically discuss the utility of drug repositioning for analgesic drug development and then show examples of ‘old’ drugs that have been successfully repositioned or that are under investigation for their analgesic actions. We conclude that drug repositioning should be more strongly encouraged to help build a bridge between basic research and pain relief worldwide.

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Acknowledgments

We thank Dr. Johannes Schlachetzki for critical reading of this manuscript. No funding was provided to support this work.

Conflict of interest

L. F. S. Bastos and M. M. Coelho report no conflict of interest.

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  1. Laboratório de Imunofarmacologia, sala O4-202, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Avenida Antônio Carlos 6627, Pampulha, Belo Horizonte, CEP 31.270-901, Brazil

    Leandro Francisco Silva Bastos

  2. Laboratório de Farmacologia, Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, UFMG, Belo Horizonte, Brazil

    Márcio Matos Coelho

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  1. Leandro Francisco Silva Bastos
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Correspondence to Leandro Francisco Silva Bastos.

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Bastos, L.F.S., Coelho, M.M. Drug Repositioning: Playing Dirty to Kill Pain. CNS Drugs 28, 45–61 (2014). https://doi.org/10.1007/s40263-013-0128-0

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