Challenging on drug combination

Drug combination represents an important field of research for a long series of reason. Firstly drug combination could have a therapeutic advantage if it generates synergy, so when the activity of two drug given in combination is higher than the sum of the activity of each drug given alone.

Unfortunately, synergy in the activity often determines synergy also in side effects. In literature it’s reported that synergistic combination could arise in more specific and particular cellular context than single agent activities. A simulation of bacterial metabolism allowed to perform multi-dose experiments relevant to several diseases and outlined the combinations that gave selective synergy in respect of drug target activity. For instance, an anti-inflammatory drug showed an increasing selectivity through different expression level of the target of another drug. The specificity of synergistic combinations generates new opportunities for therapeutic approach to improve the control of cellular system, so complex and interesting. Moreover, synergy could lead to decrease effective doses of the drug and, maybe, reduced collateral effects. Finally, formulation of couple of drugs in one pill could improve also the patient compliance. Much work has to be done to identify new combinations specially for drugs whose patent is terminated.