4. Conclusion
Since the beginning of the outbreak, a large number of clinical studies have been registered worldwide and several drugs were repurposed to face the new health emergency of COVID-19. We described pharmacological properties and available clinical data for several drugs, mainly antiviral, immune-modulatory and anti-inflammatory agents. For many of these drugs, including lopinavir/ritonavir, remdesivir, favipiravir, chloroquine and tocilizumab, clinical evidence from literature and real life settings support their favorable efficacy and safety profile in improving patients’ clinical conditions.
Considering that nowadays no specific treatments are available for COVID-19, drugs repurposing is necessary but it requires caution. Indeed, too many drugs that are currently tested in patients with COVID-19 have an unknown efficacy profile; on the other hand, those with proven efficacy have a peculiar safety profile, which calls for a strict monitoring of treated patients. Therefore, patients treated with this drug should undergo a routine monitoring. Furthermore, as reported by The Liverpool Drug Interaction Group, particular attention should be given at adverse events deriving from drug-drug interactions, which could be very common in patients with COVID-19, given the huge amount of pharmacological therapies to which they are subjected to [119 ].
Worldwide regulatory agencies are promoting all interventions to ensure strategic coordination and guarantee access to effective and safe medicines, though no proven specific therapies are available to prevent or treat COVID-19. In addition, on March 18th the EMA and the US FDA jointly chaired the first global regulatory meeting experts to support proceeding to first-in-human clinical studies [120 ]. Since SARS-Cov-2 is still an unknown virus, we are now learning its transmission mechanisms, clinical spectrum of disease, diagnostics and lethality. While waiting for the results of clinical studies demonstrating the efficacy of drugs able to reduce symptoms and complications of COVID-19, the best therapeutic path to pursue is the development of an effective vaccine able to prevent this infection.
Acknowledgements : We are grateful for the help and support of the Italian Society of Pharmacology (SIF) and its Section of Clinical Pharmacology “Giampaolo Velo”.