Drug repurposing for drug development in stroke.

The development of new treatments for acute stroke has been fraught with costly and spectacularly disappointing failures. Repurposing of drugs already known to be safe provides a lower risk alternative. Investigators are using drug repurposing, in which marketed drugs are exploited for their secondary activity, to pursue agents that have multiple mechanisms of action, including vascular protection. Protecting the ischemic vasculature is likely to promote neuronal recovery and have long-lasting benefits for patients with stroke. Currently, reperfusion with drugs or devices and acute aspirin therapy are used clinically to reduce disability due to ischemic stroke. In the future, drugs such as statins, angiotensin II receptor blockers, minocycline, and growth factors such as erythropoietin may be used. In fact, vascular protection with the angiotensin II receptor blocker candesartan has already been demonstrated in a clinical trial of acute ischemic stroke.