An introduction to repurposed drugs as a treatment option
November 12, 2017
What are repurposed drugs?
Drug repurposing is the application of known pharmaceutical drugs to treat new diseases.
Repurposed drugs might also be known as drug repositioning. re-profiling, re-tasking, therapeutic switching or off-label drugs.
Metformin, by way of example, is an established drug used for the treatment of diabetes, repurposed for use in the treatment of cancer.
In reference to drugs approval processes for prescribing through UK mass health services, these drugs:
- have not gone through double-blind, human, randomised drugs trials for the treatment of the new disease. Such a trial, with a favourable outcome, is required by NICE (the National Institute for Clinical Excellence) to approve the drug for use as new treatment for this new application,
- are attractive treatment options in the eyes of patients because they can be kinder to the body, with better knowledge of side-effects. These drugs will have typically been used by significant numbers of patients over long periods of time,
- are more difficult to fund through clinical trials because they are off-patent. Being off-patent, the competition in supply will have forced prices down such that there is insufficient money for the pharmaceutical companies to fund trials. Such commercial funding is the typical route for new drugs progressing through NICE approval processes. In the absence of commercial funds the use of scarce public funds is almost the only alternative. Attempts at crowd funding have, thus far, been unsuccessful.
At the time of writing, some repurposed drugs (specifically Metformin) are going through clinical trials with the NHS, funded by public money. However, these processes are such that these drugs, if successful, may get onto NHS approved prescription lists 5 – 10 years after they are available through other means.
What patients need to consider when contemplating use of repurposed drugs
Fundamentally, the use of repurposed drugs requires the patient to take a more active role in the decision making about what treatment protocols to follow. I argue very strongly that this is a good thing. Indeed, taking responsiblity and being more critical of recommendations is a good thing. We seem to have forgotten that we are unique individuals and that the recommendations of a medical health service will reflect the biases of this service. These biases may include, amongst other things, cost, ease of prescribing or characteristics of the approval process. This is not to say that these biases are wrong, but that they are unlikely to be right when every person’s illness is unique: a mass market solution is unlikely to be the right one for everyone.
Taking more responsibility in the decision making over a treatment therefore requires the patient to:
- Do their own research
- Have the courage to go with their own feelings. Inevitably this will mean having the courage to ignore some opinion. This might be especially difficult if this opinion comes from a loved one or from a person respected for their opinion in other areas of expertise (eg conventional oncologists do not understand drug repurposing)
- look to non standard sources of information (eg social media patient groups, websites, books, direct with private clinics, overseas clinics)
- be open-minded. The lack of evidence does not mean that these drugs don’t work. Often there is plenty of evidence, it is just that the evidence is in the form of very many independent single cases. This evidence is clearly different to a single, mass trial. In some cases the evidence, in any form, may not exist. This does not prove that the treatment does not work, but simply that the process of proving evidence, to a given format, has not been undertaken.
(Double-blind randomised trials have their merits and their drawbacks. It does not make them right or wrong. It simply means that this methodology
- has been chosen to be the right process for approving drugs for a mass prescription body, such as the NHS, where the latter must be seen to be accountable for the best use of public money.
- produce approval outcomes that are characteristic of the process. There is systemic bias, just as there is in everything in life. A different process, with different intrinsic bias, will produce different outcomes).
My Experience with Repurposed drugs
In March 2017 I decided to replace the standard NHS treatment for my cancer with the drugs protocol recommended by The Care Oncology Clinic.
The normal recommendation of Care Oncology is to use their protocol in addition to other pharmaceutical treatments. I decided that I would trial the use of the Care Oncology drug protocol as the only pharmaceutical protocol that I would follow because I implement a signficant number of other ‘lifestyle medicine’ protocols.
I have yet to conclude if this protocol if effective for me.
Repurposed drug articles and resources
Prescribing clinics in the UK
The Care Oncology Clinic, Harley Street, London.
See the resources section of this website for further information.
I am not qualified to give medical advice. All information appearing on this website simply reflects my experience and opinion. You are encouraged to do your own research and come to your own conclusions.