Drug repositioning and repurposing for Alzheimer disease.
Clive G BallardDag AarslandJeffrey CummingsJohn Tiernan O'BrienRoger MillsJose Luis MolinuevoTormod FladbyGareth WilliamsPat DohertyAnne CorbettJanet SultanaPublished in: Nature reviews. Neurology (2020)
Drug repositioning and repurposing can enhance traditional drug development efforts and could accelerate the identification of new treatments for individuals with Alzheimer disease (AD) dementia and mild cognitive impairment. Transcriptional profiling offers a new and highly efficient approach to the identification of novel candidates for repositioning and repurposing. In the future, novel AD transcriptional signatures from cells isolated at early stages of disease, or from human neurons or microglia that carry mutations that increase the risk of AD, might be used as probes to identify additional candidate drugs. Phase II trials assessing repurposed agents must consider the best target population for a specific candidate therapy as well as the mechanism of action of the treatment. In this Review, we highlight promising compounds to prioritize for clinical trials in individuals with AD, and discuss the value of Delphi consensus methodology and evidence-based reviews to inform this prioritization process. We also describe emerging work, focusing on the potential value of transcript signatures as a cost-effective approach to the identification of novel candidates for repositioning.
Keyphrases
- mild cognitive impairment
- clinical trial
- phase ii
- cognitive decline
- highly efficient
- open label
- bioinformatics analysis
- endothelial cells
- induced apoptosis
- transcription factor
- small molecule
- genome wide
- spinal cord
- inflammatory response
- emergency department
- stem cells
- systematic review
- phase iii
- heat shock
- oxidative stress
- adverse drug
- cell proliferation
- neuropathic pain
- cognitive impairment
- current status
- spinal cord injury
- risk assessment
- pluripotent stem cells
- fluorescence imaging
- signaling pathway
- electronic health record