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Multitarget drug discovery projects in CNS diseases: quantitative systems pharmacology as a possible path forward

Future Med Chem. 2014;6(16):1757-69. doi: 10.4155/fmc.14.97.

Abstract

Clinical development in brain diseases has one of the lowest success rates in the pharmaceutical industry, and many promising rationally designed single-target R&D projects fail in expensive Phase III trials. By contrast, successful older CNS drugs do have a rich pharmacology. This article will provide arguments suggesting that highly selective single-target drugs are not sufficiently powerful to restore complex neuronal circuit homeostasis. A rationally designed multitarget project can be derisked by dialing in an additional symptomatic treatment effect on top of a disease modification target. Alternatively, we expand upon a hypothetical workflow example using a humanized computer-based quantitative systems pharmacology platform. The hope is that incorporating rationally multipharmacology drug discovery could potentially lead to more impactful polypharmacy drugs.

MeSH terms

  • Central Nervous System Agents / therapeutic use*
  • Central Nervous System Diseases / drug therapy*
  • Drug Discovery*
  • Humans
  • Polypharmacology*
  • Systems Biology*

Substances

  • Central Nervous System Agents