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retraso, con obvios efectos delet%u00e9reos sobre lahumanidad y sobre el resto de seres vivos; y, loque no es menos relevante, sobre el conocimiento.As%u00ed pues, una parte notable del esfuerzoinvestigador de los cient%u00edficos y de lasinstituciones acad%u00e9micas y empresariales que losoportan va encaminado a revaluar eso quecre%u00edamos saber y que, en realidad, solo era elsimple resplandor de una superficie a vecesdeslumbrante pero que suele encubrir un profundoy desconocido oc%u00e9ano de realidad. En el %u00e1mbitode la biomedicina, la reevaluaci%u00f3n continua hapermitido ver con actitud diferente lo que siempreha estado delante de nuestros ojos; gran parte delos medicamentos procedentes de la qu%u00edmicasint%u00e9tica, la biotecnolog%u00eda y las terapias avanzadas(gen%u00e9tica, som%u00e1tica, ingenier%u00eda tisular, etc.) sonun ejemplo patente de todo lo dicho.Por innovaci%u00f3n terap%u00e9utica puede entendersecualquier mejora de un nuevo producto oprocedimiento cl%u00ednico de uno o varios aspectos de1. INTRODUCCI%u00d3NEl avance cient%u00edfico es el resultado de un esfuerzom%u00faltiple que no solo busca lo nunca visto sino,sobre todo, comprender. Ver no es igual queobservar; observar no es lo mismo que entender;entender no es lo mismo que comprender. Sonprocesos necesariamente progresivos delconocimiento que, sin embargo, deben serentendidos de forma retroactiva o circular, porquecomprender nos lleva siempre a volver a ver %u2013ahora ya con otros ojos %u2013 lo que anteriormentecre%u00edamos conocer. Como dijo Erwin Schr%u00f6dinger,%u201cla tarea no es tanto ver lo que nadie ha vistotodav%u00eda, sino pensar lo que nadie ha pensadotodav%u00eda sobre lo que todos ven%u201d. Si SantiagoRam%u00f3n y Cajal no hubiera %u201cvisto con otros ojos%u201d lacompleja estructura neuronal del sistema nerviososeguramente la evoluci%u00f3n de la fisiolog%u00eda, de laanatom%u00eda y, en general, de la medicina %u2013 y de laveterinaria %u2013 habr%u00eda sufrido un considerableANALESRANFwww.analesranf.comTherapeutic repositioning: importance of newtherapeutic indications approved for oldmedicinesSantiago Cu%u00e9llar Rodr%u00edguezAn. R. Acad. Farm.Vol. 90. n%u00ba 2 (2024) %u00b7 pp. 239-256ABSTRACTIn the field of health and, particularly in biomedicine, continuous reevaluation hasallowed us to see with a different attitude what was apparently known; A largepart of the medicines from synthetic chemistry, biotechnology and advancedtherapies (genetics, somatics, tissue engineering, etc.) are a clear example of this.The search and investigation of new applications for drugs already approved andin clinical use %u2013 and even for compounds that did not reach the clinical researchphases at the time %u2013 is usually called %u201crepositioning%u201d, which makes it possible tohave drugs with a profile of safety and efficacy already known, which representsa significant saving in time and development costs and, sometimes, is the only wayto develop therapies for rare diseases, as orphan indications. In fact, it isestimated that a substantial part of the known drugs may have new therapeuticuses and that drugs currently in clinical use could be used for numerousapplications other than those for which they were originally approved. The highnumber of authorizations of new indications or their extensions or modificationsby the EMA and the FDA, in relation to that of medicines with new activeingredients, highlights that pharmacological research %u2013 basic and clinical %u2013 doesnot end with the marketing authorization of a medicine but, on the contrary, thereare many that continue to be the subject of extensive and intensive research bytheir titular laboratories in order to extract the maximum knowledge and healthresults from products whose development has a very high economic cost andrequires large and multidisciplinary human research teams. In order to examinethe current innovative activity in the field of new indications for medicinespreviously authorized in the European Union, we have proceeded to systematicallycollect and study the contents of all the summaries of the 36 plenary meetings ofthe Committee for Medicinal Products for Human Use (CHMP) published by the EMAbetween January 2021 and March 2024, in which 258 positive recommendationsfor extension of indications were made, for a total of 181 medicines from 74laboratories.KEYWORDS Pharmacologytherapeuticrepositioningclinical researchdrug authorizationdrug evaluation240