Drug repurposing is the use of a given therapeutic agent for indications other than that for which it was originally designed or intended. The concept is appealing because of potentially lower development costs and shorter timelines than are needed to produce a new drug. To date, drug repurposing for cardiovascular indications has been opportunistic and driven by knowledge of disease mechanisms or serendipitous observation rather than by systematic endeavours to match an existing drug to a new indication. Innovations in two areas of personalized medicine — computational approaches to associate drug effects with disease signatures and predictive model systems to screen drugs for disease-modifying activities — support efforts that together create an efficient pipeline to systematically repurpose drugs to treat cardiovascular disease. Furthermore, new experimental strategies that guide the medicinal chemistry re-engineering of drugs could improve repurposing efforts by tailoring a medicine to its new indication. In this Review, we summarize the historical approach to repurposing and discuss the technological advances that have created a new landscape of opportunities.

药物再利用是将给定的治疗剂用于其最初设计或预期的适应症以外的适应症。这个概念很有吸引力，因为开发成本可能比生产新药所需的时间更短。迄今为止，心血管适应症的药物再利用一直是机会主义的，并且受疾病机制知识或偶然观察的驱动，而不是通过系统努力将现有药物与新适应症相匹配。个性化医疗两个领域的创新——将药物效应与疾病特征联系起来的计算方法和用于筛选药物以改善疾病活动的预测模型系统——支持共同创建有效管道的努力，以系统地重新利用药物来治疗心血管疾病。此外，指导药物化学再造的新实验策略可以通过根据新适应症调整药物来改善再利用工作。在这篇评论中，我们总结了重新利用的历史方法，并讨论了创造新机遇的技术进步。