Revisão bibliográfica: reposicionamento de fármacos antivirais no tratamento da COVID-19
Data
2022-11-24
Autores
Higa, Daniela Lameiras [UNIFESP]
Orientadores
Reis, Adriana Karla Cardoso Amorim [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O reposicionamento de fármacos é uma estratégia onde utilizam fármacos já conhecidos e validados para o tratamento de novas doenças, é uma técnica mais rápida e barata. Com o surgimento da pandemia de COVID-19 (11 de março de 2020), diversas indústrias farmacêuticas recorreram ao reposicionamento para tentar obter fármacos eficazes no menor tempo possível. Essa nova doença é causada por um novo vírus da família do coronavírus, o SARS-CoV-2, que é constituído por quatro proteínas estruturais: spike (S), nucleocapsídeo (N), membrana (M) e envelope (E); e 16 proteínas não estruturais (NSP) que são identificadas de 1 a 16, sendo que cada uma delas tem uma função específica na infecção do vírus. Sabendo-se a estrutura, a composição e como o novo vírus age no nosso organismo, é possível analisar fármacos já existentes que inibam processos vitais para o seu ciclo de vida, sendo alguns deles: proteases, fusão da membrana, RNA polimerase dependente de RNA (RdRp), etc. Nesta revisão serão reunidos artigos de potenciais fármacos antivirais reposicionados para o combate a COVID-19 através das plataformas PubMed, Web of Science, SciELO, Google Acadêmico e o site ClinicalTrials.gov, no período de 2020 a 2022. Foi observado que o arbidol (inibidor de fusão) não tem um mecanismo de ação detalhado e que apenas os resultados in vitro foram positivos; o remdesivir (inibidor de RdRp) foi aprovado para uso emergencial, mas com muitas controvérsias com relação ao seu real benefício; o molnupiravir (inibidor de RdRp) foi aprovado para uso emergencial e foi eficiente no tratamento precoce da COVID-19; e o nirmatrelvir + ritonavir também teve seu uso emergencial aprovado, assim como a venda em farmácias.
The repositioning of drugs is a strategy where they use drugs already known and validated for the treatment of new diseases, it is a faster and cheaper technique. With the emergence of the COVID-19 pandemic (March 11, 2020), several pharmaceutical industries resorted to repositioning to try to obtain effective drugs in the shortest possible time. This new disease is caused by a new virus from the coronavirus family, SARS-CoV-2, which consists of four structural proteins: spike (S), nucleocapsid (N), membrane (M) and envelope (E); and 16 non-structural proteins (NSP) that are identified from 1 to 16, each of which has a specific function in the infection of the virus. Knowing the structure, composition and how the new virus acts in our body, it is possible to analyze existing drugs that inhibit vital processes for its life cycle, some of which are: proteases, membrane fusion, RNA-dependent RNA polymerase (RdRp), etc. This review will gather articles on potential antiviral drugs repositioned to combat COVID-19 through PubMed, Web of Science, SciELO, Google Scholar and ClinicalTrials.gov platforms, from 2020 to 2022. It was observed that arbidol ( fusion inhibitor) does not have a detailed mechanism of action and that only in vitro results were positive; remdesivir (RdRp inhibitor) was approved for emergency use, but with many controversies regarding its real benefit; molnupiravir (RdRp inhibitor) was approved for emergency use and was effective in the early treatment of CIVID-19; and nirmatrelvir + ritonavir also had its emergency use approved, as well as its sale in pharmacies.
The repositioning of drugs is a strategy where they use drugs already known and validated for the treatment of new diseases, it is a faster and cheaper technique. With the emergence of the COVID-19 pandemic (March 11, 2020), several pharmaceutical industries resorted to repositioning to try to obtain effective drugs in the shortest possible time. This new disease is caused by a new virus from the coronavirus family, SARS-CoV-2, which consists of four structural proteins: spike (S), nucleocapsid (N), membrane (M) and envelope (E); and 16 non-structural proteins (NSP) that are identified from 1 to 16, each of which has a specific function in the infection of the virus. Knowing the structure, composition and how the new virus acts in our body, it is possible to analyze existing drugs that inhibit vital processes for its life cycle, some of which are: proteases, membrane fusion, RNA-dependent RNA polymerase (RdRp), etc. This review will gather articles on potential antiviral drugs repositioned to combat COVID-19 through PubMed, Web of Science, SciELO, Google Scholar and ClinicalTrials.gov platforms, from 2020 to 2022. It was observed that arbidol ( fusion inhibitor) does not have a detailed mechanism of action and that only in vitro results were positive; remdesivir (RdRp inhibitor) was approved for emergency use, but with many controversies regarding its real benefit; molnupiravir (RdRp inhibitor) was approved for emergency use and was effective in the early treatment of CIVID-19; and nirmatrelvir + ritonavir also had its emergency use approved, as well as its sale in pharmacies.