MedCare

Detecting novel drug combinations associated with adverse events

Started
September 1, 2023
Status
In Progress
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Abstract

Drug-drug interactions (DDIs) are a leading cause of adverse drug events (ADEs), which are a major cause of preventable harm and mortality. While a small number of DDIs are known at the time of market approval, based on the pharmacokinetics of drug metabolism, the potential for additive effects from multi-drug combinations (MDCs) in patients with high medication use (polypharmacy) remains largely unknown. Moreover, as the number of possible drug combinations is immense in patients with high medication use (>1 billion), it is not possible to identify new harmful DDIs using traditional methods.

Thus, advances in machine learning (ML) that can identify harmful MDCs while addressing causal inference (i.e., time relationships) are needed. The MedCare project aims to develop and apply new approaches to identify and evaluate DDIs in large healthcare data.

This project is co-funded by PHRT.

People

Collaborators

SDSC Team:
Paraskevi Nousi
Maxim Samarin
Leonid Iosipoi
Ekaterina Krymova

PI | Partners:

ETH Zurich, Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Pharmacoepidemiology:

  • Prof. Dr. Andrea Burden
  • Dr. Adrian Martinez de la Torre
  • Franziska Ulrich

More info

description

Motivation

The risk of an interaction between two or more drugs leading to a DDI is elevated in patients taking multiple medications (i.e., polypharmacy). The objective of MedCare is to develop new approaches to identify new DDIs or MDCs associated with ADEs in real-world post-market healthcare data. With these approaches, we expect to improve the detection and evaluation of previously undetected adverse drug events associated with MDCs. Importantly, as the results of MedCare will have direct relevance to the medical care of patients, an emphasis on transparency and interpretability is a primary focus.

Proposed Approach/Solution

MedCare aims to overcome the limitations of current approaches by combining the strengths of machine learning (ML) developed with the methodological knowledge of pharmacoepidemiology and electronic pharmacovigilance as well as medical record data. The project will have two main components: (1) to develop and refine ML models that can detect drug interactions in pharmacovigilance data, and (2) adapt ML for pharmacovigilance data to electronic healthcare data that includes longitudinal (i.e., time-series) patient data.

Impact

MedCare will advance our scientific knowledge of how to best identify new harmful DDIs using ML methods. If successful, the approaches used in MedCare will be an important step forward for developing ML models that can detect harmful drug combinations and extend beyond a two-drug interaction approach. These results will advance the knowledge of harmful DDIs and will ideally be used to improve patient safety.

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Annexe

Cover image source: Adobe Stock

Additional resources

Bibliography

  1. Basile, A. O., Yahi, A., & Tatonetti, N. P. (2019). Artificial intelligence for drug toxicity and safety. Trends in Pharmacological Sciences, 40(9), 624–635. https://doi.org/10.1016/j.tips.2019.07.005
  2. Blozik, E., Rapold, R., von Overbeck, J., & Reich, O. (2013). Polypharmacy and potentially inappropriate medication in the adult, community-dwelling population in Switzerland. Drugs & Aging, 30, 561–568. https://doi.org/10.1007/s40266-013-0073-0
  3. Dumbreck, S., Flynn, A., Nairn, M., Wilson, M., Treweek, S., Mercer, S. W., Alderson, P., Thompson, A., Payne, K., & Guthrie, B. (2015). Drug-disease and drug-drug interactions: systematic examination of recommendations in 12 UK national clinical guidelines. BMJ (Online), 350, 1–8. https://doi.org/10.1136/bmj.h949
  4. Marengoni, A., & Onder, G. (2015). Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity. BMJ (Online), 350, 1059. https://doi.org/10.1136/bmj.h1059
  5. Tatonetti, N. P., Fernald, G. H., & Altman, R. B. (2012). A novel signal detection algorithm for identifying hidden drug-drug interactions in adverse event reports. Journal of the American Medical Informatics Association, 19(1), 79–85. https://doi.org/10.1136/amiajnl-2011-000214
  6. Tatonetti, N. P., Ye, P. P., Daneshjou, R., & Altman, R. B. (2012). Data-driven prediction of drug effects and interactions. Science Translational Medicine, 4(125), 125ra31. https://doi.org/10.1126%2Fscitranslmed.3003377  

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