1. Why Certain Repurposed Drugs Are Unlikely to Be Effective Antivirals to Treat SARS-CoV-2 Infections
- Author
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Selwyn J. Hurwitz, Ramyani De, Julia C. LeCher, Jessica A. Downs-Bowen, Shu Ling Goh, Keivan Zandi, Tamara McBrayer, Franck Amblard, Dharmeshkumar Patel, James J. Kohler, Manoj Bhasin, Brian S. Dobosh, Vikas Sukhatme, Rabindra M. Tirouvanziam, and Raymond F. Schinazi
- Subjects
drug repurposing ,SARS-CoV-2 ,COVID-19 ,coronavirus ,potency ,pharmacokinetics ,Microbiology ,QR1-502 - Abstract
Most repurposed drugs have proved ineffective for treating COVID-19. We evaluated median effective and toxic concentrations (EC50, CC50) of 49 drugs, mostly from previous clinical trials, in Vero cells. Ratios of reported unbound peak plasma concentrations, (Cmax)/EC50, were used to predict the potential in vivo efficacy. The 20 drugs with the highest ratios were retested in human Calu-3 and Caco-2 cells, and their CC50 was determined in an expanded panel of cell lines. Many of the 20 drugs with the highest ratios were inactive in human Calu-3 and Caco-2 cells. Antivirals effective in controlled clinical trials had unbound Cmax/EC50 ≥ 6.8 in Calu-3 or Caco-2 cells. EC50 of nucleoside analogs were cell dependent. This approach and earlier availability of more relevant cultures could have reduced the number of unwarranted clinical trials.
- Published
- 2024
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