Strategies for Redesigning Withdrawn Drugs to Enhance Therapeutic Efficacy and Safety: A Review

Drug toxicity and market withdrawals are two issues that often obstruct the lengthy and intricate drug discovery process. In order to enhance drug effectiveness and safety, this review examines withdrawn drugs and presents a novel paradigm for their redesign. In addition to addressing methodological issues with toxicity datasets, this study highlights important shortcomings in in silico drug toxicity prediction models and suggests solutions. High-throughput screening (HTS) has greatly progressed with the advent of 3D organoid and organ-on-chip (OoC) technologies, which provide physiologically appropriate systems that replicate the structure and function of human tissue. These systems provide accurate, human-relevant data for drug development, toxicity evaluation, and disease modeling, overcoming the limitations of traditional 2D cell cultures and animal models. Their integration into HTS pipelines has shown to have a major influence, promoting drug redesign efforts and enabling improved accuracy in preclinical research. The potential of fragment-based drug discovery to enhance pharmacokinetics (PK) and pharmacodynamics (PD) when combined with conventional techniques is highlighted in this study. The limits of animal models are discussed, with a focus on the need of bioengineered humanized systems such OoC technologies and 3D organoids. To improve drug candidate screening and simulate real illnesses, advanced models are crucial. This leads to improved target affinity and fewer adverse effects.