by Boffito M, Back DJ, Flexner C, Sjö P, Blaschke TF, Horby PW, Cattaneo D, Acosta EP, Anderson P, Owen A. Clinical Pharmacology & Therapeutics 2020. doi: 10.1002/cpt.2099
Summary: The SARS‐CoV‐2 pandemic has brought scientists from diverse backgrounds together in an unprecedented international effort to rapidly identify interventions. The principles of clinical pharmacology must be applied to these efforts and, in particular, the influence of plasma and tissue protein binding on pharmacokinetics and pharmacodynamics. The principles of free drug theory are not currently being routinely applied to SARS‐CoV‐2 antiviral drugs. Consideration of protein binding is critically important to candidate selection but requires correct interpretation, in a drug‐specific manner, to avoid either under‐ or over‐interpretation of its consequences. The authors present a consensus from international researchers who have sought to apply historical knowledge from highly successful antiviral drug development for other viruses such as HIV and HCV.