Drug repurposing to identify new therapeutic options
Loss of vision is one of the most common adverse events of older age, being associated with loss of independence, loss of earnings (for the individual and carers) and profound impact on quality of life. Globally, age-related macular degeneration (AMD) in its late stages is a leading cause of blindness, and moderate and severe vision impairment in adults aged 50 years and over. Although the advent of anti-vascular endothelial growth factor drugs has dramatically improved the outcomes of wet AMD patients, there are no treatments for the remaining majority of dry AMD patients.
Using Dexter, at pace, we undertook a series of analysis to find suitable treatment options for dry AMD. We were able to undertake a variety of pharmaco-epidemiology approaches; starting with a time-dependent exposure design, directed by proposed biological mechanisms, we were able to examine whether Metformin would be a suitable treatment agent. Although, this demonstrated no relationship, we then went to (powered by Dexter) undertake a signal generating exercise finding suitable therapy modalities among all remaining oral medications. Positive signals were identified for several medications, among which Memantine proved most promising. As such, this has led to exploration of trialling this medication as the first potential therapeutic option for dry AMD.