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”.