The dark side of drug repurposing. From clinical trial challenges to antimicrobial resistance: analysis based on three major fields

Iyad Y. Natsheh; Majd M. Alsaleh; Ahmad K. Alkhawaldeh; Duaa K. Albadawi; Maisa’ M. Darwish; Mohammed Jamal A. Shammout

doi:10.33393/dti.2024.3019

Authors

Iyad Y. Natsheh Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt - Jordan https://orcid.org/0000-0002-8121-7281
Majd M. Alsaleh Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt - Jordan and Department of Biology, School of Science, University of Jordan, Amman - Jordan https://orcid.org/0000-0003-4677-8558
Ahmad K. Alkhawaldeh Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt - Jordan https://orcid.org/0000-0003-4348-6613
Duaa K. Albadawi Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt - Jordan https://orcid.org/0009-0005-2670-3526
Maisa’ M. Darwish Department of Biology, School of Science, University of Jordan, Amman - Jordan and National Agricultural Research Center, Amman - Jordan https://orcid.org/0009-0004-0954-7245
Mohammed Jamal A. Shammout Chemistry Department, Faculty of Science, Applied Science Private University, Amman - Jordan https://orcid.org/0000-0003-4593-6366

DOI:

https://doi.org/10.33393/dti.2024.3019

Keywords:

Thalidomide, Levofloxacin, Minocycline, Doxycycline, Azithromycin, Hydroxychloroquine

Abstract

Drug repurposing is a strategic endeavor that entails the identification of novel therapeutic applications for pharmaceuticals that are already available in the market. Despite the advantageous nature of implementing this particular strategy owing to its cost-effectiveness and efficiency in reducing the time required for the drug discovery process, it is essential to bear in mind that there are various factors that must be meticulously considered and taken into account. Up to this point, there has been a noticeable absence of comprehensive analyses that shed light on the limitations of repurposing drugs. The primary aim of this review is to conduct a thorough illustration of the various challenges that arise when contemplating drug repurposing from a clinical perspective in three major fields—cardiovascular, cancer, and diabetes—and to further underscore the potential risks associated with the emergence of antimicrobial resistance (AMR) when employing repurposed antibiotics for the treatment of noninfectious and infectious diseases. The process of developing repurposed medications necessitates the application of creativity and innovation in designing the development program, as the body of evidence may differ for each specific case. In order to effectively repurpose drugs, it is crucial to consider the clinical implications and potential drawbacks that may arise during this process. By comprehensively analyzing these challenges, we can attain a deeper comprehension of the intricacies involved in drug repurposing, which will ultimately lead to the development of more efficacious and safe therapeutic approaches.

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