An integrative machine learning approach for prediction of toxicity-related drug safety

Advancing Drug Safety in Drug Development: Bridging Computational Predictions for Enhanced Toxicity Prediction

The attrition rate of drugs in clinical trials is generally quite high, with estimates suggesting that approximately 90% of drugs fail to make it through the process. The identification of unexpected toxicity issues during preclinical stages is a significant factor contributing to this high rate of failure. These issues can have a major impact on the success of a drug and must be carefully considered throughout the development process. These late-stage rejections or withdrawals of drug candidates significantly increase the costs associated with drug development, particularly when toxicity is detected during clinical trials or after market release. Understanding drug-biological target interactions is essential for evaluating compound toxicity and safety, as well as predicting therapeutic effects and potential off-target effects that could lead to toxicity. This will enable scientists to predict and assess the safety profiles of drug candidates more accurately. Evaluation of toxicity and safety is a critical aspect of drug development, and biomolecules, particularly proteins, play vital roles in complex biological networks and often serve as targets for various chemicals. Therefore, a better understanding of these interactions is crucial for the advancement of drug development. The development of computational methods for evaluating protein-ligand interactions and predicting toxicity is emerging as a promising approach that adheres to the 3Rs principles (replace, reduce, and refine) and has garnered significant attention in recent years. In this review, we present a thorough examination of the latest breakthroughs in drug toxicity prediction, highlighting the significance of drug-target binding affinity in anticipating and mitigating possible adverse effects. In doing so, we aim to contribute to the development of more effective and secure drugs.

The Role of AI in Drug Discovery

The emergence of Artificial Intelligence (AI) in drug discovery marks a pivotal shift in pharmaceutical research, blending sophisticated computational techniques with conventional scientific exploration to break through enduring obstacles. This review paper elucidates the multifaceted applications of AI across various stages of drug development, highlighting significant advancements and methodologies. It delves into AI's instrumental role in drug design, polypharmacology, chemical synthesis, drug repurposing, and the prediction of drug properties such as toxicity, bioactivity, and physicochemical characteristics. Despite AI's promising advancements, the paper also addresses the challenges and limitations encountered in the field, including data quality, generalizability, computational demands, and ethical considerations. By offering a comprehensive overview of AI's role in drug discovery, this paper underscores the technology's potential to significantly enhance drug development, while also acknowledging the hurdles that must be overcome to fully realize its benefits.

A comprehensive overview of advanced dynamic in vitro intestinal and hepatic cell culture models

Orally administered drugs pass through the gastrointestinal tract before being absorbed in the small intestine and metabolised in the liver. To test the efficacy and toxicity of drugs, animal models are often employed; however, they are not suitable for investigating drug-tissue interactions and making reliable predictions, since the human organism differs drastically from animals in terms of absorption, distribution, metabolism and excretion of substances. Likewise, simple static in vitro cell culture systems currently used in preclinical drug screening often do not resemble the native characteristics of biological barriers. Dynamic models, on the other hand, provide in vivo-like cell phenotypes and functionalities that offer great potential for safety and efficacy prediction. Herein, current microfluidic in vitro intestinal and hepatic models are reviewed, namely single- and multi-tissue micro-bioreactors, which are associated with different methods of cell cultivation, i.e., scaffold-based versus scaffold-free.

Clustering Protein Binding Pockets and Identifying Potential Drug Interactions: A Novel Ligand-Based Featurization Method

Protein-ligand interactions are essential to drug discovery and drug development efforts. Desirable on-target or multitarget interactions are the first step in finding an effective therapeutic, while undesirable off-target interactions are the first step in assessing safety. In this work, we introduce a novel ligand-based featurization and mapping of human protein pockets to identify closely related protein targets and to project novel drugs into a hybrid protein-ligand feature space to identify their likely protein interactions. Using structure-based template matches from PDB, protein pockets are featured by the ligands that bind to their best co-complex template matches. The simplicity and interpretability of this approach provide a granular characterization of the human proteome at the protein-pocket level instead of the traditional protein-level characterization by family, function, or pathway. We demonstrate the power of this featurization method by clustering a subset of the human proteome and evaluating the predicted cluster associations of over 7000 compounds.

Federated Learning in Computational Toxicology: An Industrial Perspective on the Effiris Hackathon

In silico approaches have acquired a towering role in pharmaceutical research and development, allowing laboratories all around the world to design, create, and optimize novel molecular entities with unprecedented efficiency. From a toxicological perspective, computational methods have guided the choices of medicinal chemists toward compounds displaying improved safety profiles. Even if the recent advances in the field are significant, many challenges remain active in the on-target and off-target prediction fields. Machine learning methods have shown their ability to identify molecules with safety concerns. However, they strongly depend on the abundance and diversity of data used for their training. Sharing such information among pharmaceutical companies remains extremely limited due to confidentiality reasons, but in this scenario, a recent concept named "federated learning" can help overcome such concerns. Within this framework, it is possible for companies to contribute to the training of common machine learning algorithms, using, but not sharing, their proprietary data. Very recently, Lhasa Limited organized a hackathon involving several industrial partners in order to assess the performance of their federated learning platform, called "Effiris". In this paper, we share our experience as Roche in participating in such an event, evaluating the performance of the federated algorithms and comparing them with those coming from our in-house-only machine learning models. Our aim is to highlight the advantages of federated learning and its intrinsic limitations and also suggest some points for potential improvements in the method.

Artificial Intelligence for Computer-Aided Drug Discovery

The continuous implementation of Artificial Intelligence (AI) in multiple scientific domains and the rapid advancement in computer software and hardware, along with other parameters, have rapidly fuelled this development. The technology can contribute effectively in solving many challenges and constraints in the traditional development of the drug. Traditionally, large-scale chemical libraries are screened to find one promising medicine. In recent years, more reasonable structure-based drug design approaches have avoided the first screening phases while still requiring chemists to design, synthesize, and test a wide range of compounds to produce possible novel medications. The process of turning a promising chemical into a medicinal candidate can be expensive and time-consuming. Additionally, a new medication candidate may still fail in clinical trials even after demonstrating promise in laboratory research. In fact, less than 10% of medication candidates that undergo Phase I trials really reach the market. As a consequence, the unmatched data processing power of AI systems may expedite and enhance the drug development process in four different ways: by opening up links to novel biological systems, superior or distinctive chemistry, greater success rates, and faster and less expensive innovation trials. Since these technologies may be used to address a variety of discovery scenarios and biological targets, it is essential to comprehend and distinguish between use cases. As a result, we have emphasized how AI may be used in a variety of areas of the pharmaceutical sciences, including in-depth opportunities for drug research and development.

Recent Advances in Toxicity Prediction: Applications of Deep Graph Learning

The development of new drugs is time-consuming and expensive, and as such, accurately predicting the potential toxicity of a drug candidate is crucial in ensuring its safety and efficacy. Recently, deep graph learning has become prevalent in this field due to its computational power and cost efficiency. Many novel deep graph learning methods aid toxicity prediction and further prompt drug development. This review aims to connect fundamental knowledge with burgeoning deep graph learning methods. We first summarize the essential components of deep graph learning models for toxicity prediction, including molecular descriptors, molecular representations, evaluation metrics, validation methods, and data sets. Furthermore, based on various graph-related representations of molecules, we introduce several representative studies and methods for toxicity prediction from the perspective of GNN architectures and graph pretrained models. Compared to other types of models, deep graph models not only advance in higher accuracy and efficiency but also provide more intuitive insights, which is significant in the development of model interpretation and generalization ability. The graph pretrained models are emerging as they can extract prominent features from large-scale unlabeled molecular graph data and improve the performance of downstream toxicity prediction tasks. We hope this survey can serve as a handbook for individuals interested in exploring deep graph learning for toxicity prediction.

The Role of AI in Drug Discovery: Challenges, Opportunities, and Strategies

Artificial intelligence (AI) has the potential to revolutionize the drug discovery process, offering improved efficiency, accuracy, and speed. However, the successful application of AI is dependent on the availability of high-quality data, the addressing of ethical concerns, and the recognition of the limitations of AI-based approaches. In this article, the benefits, challenges, and drawbacks of AI in this field are reviewed, and possible strategies and approaches for overcoming the present obstacles are proposed. The use of data augmentation, explainable AI, and the integration of AI with traditional experimental methods, as well as the potential advantages of AI in pharmaceutical research, are also discussed. Overall, this review highlights the potential of AI in drug discovery and provides insights into the challenges and opportunities for realizing its potential in this field. Note from the human authors: This article was created to test the ability of ChatGPT, a chatbot based on the GPT-3.5 language model, in terms of assisting human authors in writing review articles. The text generated by the AI following our instructions (see Supporting Information) was used as a starting point, and its ability to automatically generate content was evaluated. After conducting a thorough review, the human authors practically rewrote the manuscript, striving to maintain a balance between the original proposal and the scientific criteria. The advantages and limitations of using AI for this purpose are discussed in the last section.

A Review on Artificial Intelligence Approaches and Rational Approaches in Drug Discovery

Artificial intelligence (AI) speeds up the drug development process and reduces its time, as well as the cost which is of enormous importance in outbreaks such as COVID-19. It uses a set of machine learning algorithms that collects the available data from resources, categorises, processes and develops novel learning methodologies. Virtual screening is a successful application of AI, which is used in screening huge drug-like databases and filtering to a small number of compounds. The brain's thinking of AI is its neural networking which uses techniques such as Convoluted Neural Network (CNN), Recursive Neural Network (RNN) or Generative Adversial Neural Network (GANN). The application ranges from small molecule drug discovery to the development of vaccines. In the present review article, we discussed various techniques of drug design, structure and ligand-based, pharmacokinetics and toxicity prediction using AI. The rapid phase of discovery is the need of the hour and AI is a targeted approach to achieve this.

Past, Present, and Future Perspectives on Computer-Aided Drug Design Methodologies

The application of computational approaches in drug discovery has been consolidated in the last decades. These families of techniques are usually grouped under the common name of "computer-aided drug design" (CADD), and they now constitute one of the pillars in the pharmaceutical discovery pipelines in many academic and industrial environments. Their implementation has been demonstrated to tremendously improve the speed of the early discovery steps, allowing for the proficient and rational choice of proper compounds for a desired therapeutic need among the extreme vastness of the drug-like chemical space. Moreover, the application of CADD approaches allows the rationalization of biochemical and interactive processes of pharmaceutical interest at the molecular level. Because of this, computational tools are now extensively used also in the field of rational 3D design and optimization of chemical entities starting from the structural information of the targets, which can be experimentally resolved or can also be obtained with other computer-based techniques. In this work, we revised the state-of-the-art computer-aided drug design methods, focusing on their application in different scenarios of pharmaceutical and biological interest, not only highlighting their great potential and their benefits, but also discussing their actual limitations and eventual weaknesses. This work can be considered a brief overview of computational methods for drug discovery.

The evolving role of investigative toxicology in the pharmaceutical industry

For decades, preclinical toxicology was essentially a descriptive discipline in which treatment-related effects were carefully reported and used as a basis to calculate safety margins for drug candidates. In recent years, however, technological advances have increasingly enabled researchers to gain insights into toxicity mechanisms, supporting greater understanding of species relevance and translatability to humans, prediction of safety events, mitigation of side effects and development of safety biomarkers. Consequently, investigative (or mechanistic) toxicology has been gaining momentum and is now a key capability in the pharmaceutical industry. Here, we provide an overview of the current status of the field using case studies and discuss the potential impact of ongoing technological developments, based on a survey of investigative toxicologists from 14 European-based medium-sized to large pharmaceutical companies.

Improved Machine Learning Models by Data Processing for Predicting Life-Cycle Environmental Impacts of Chemicals

Machine learning (ML) provides an efficient manner for rapid prediction of the life-cycle environmental impacts of chemicals, but challenges remain due to low prediction accuracy and poor interpretability of the models. To address these issues, we focused on data processing by using a mutual information-permutation importance (MI-PI) feature selection method to filter out irrelevant molecular descriptors from the input data, which improved the model interpretability by preserving the physicochemical meanings of original molecular descriptors without generation of new variables. We also applied a weighted Euclidean distance method to mine the data most relevant to the predicted targets by quantifying the contribution of each feature, thereby the prediction accuracy was improved. On the basis of above data processing, we developed artificial neural network (ANN) models for predicting the life-cycle environmental impacts of chemicals with R² values of 0.81, 0.81, 0.84, 0.75, 0.73, and 0.86 for global warming, human health, metal depletion, freshwater ecotoxicity, particulate matter formation, and terrestrial acidification, respectively. The ML models were interpreted using the Shapley additive explanation method by quantifying the contribution of each input molecular descriptor to environmental impact categories. This work suggests that the combination of feature selection by MI-PI and source data selection based on weighted Euclidean distance has a promising potential to improve the accuracy and interpretability of the models for predicting the life-cycle environmental impacts of chemicals.

In-vivo processing of nanoassemblies: a neglected framework for recycling to bypass nanotoxicological therapeutics

The proof-of-concept of nanomaterials (NMs) in the fields of imaging, diagnosis, treatment, and theranostics shows the importance in biopharmaceuticals development due to structural orientation, on-targeting, and long-term stability. However, biotransformation of NMs and their modified form in human body via recyclable techniques are not explored owing to tiny structures and cytotoxic effects. Recycling of NMs offers advantages of dose reduction, re-utilization of the administered therapeutics providing secondary release, and decrease in nanotoxicity in human body. Therefore, approaches like in-vivo re-processing and bio-recycling are essential to overcome nanocargo system-associated toxicities such as hepatotoxicity, nephrotoxicity, neurotoxicity, and lung toxicity. After 3-5 stages of recycling process of some NMs of gold, lipid, iron oxide, polymer, silver, and graphene in spleen, kidney, and Kupffer's cells retain biological efficiency in the body. Thus, substantial attention towards recyclability and reusability of NMs for sustainable development necessitates further advancement in healthcare for effective therapy. This review article outlines biotransformation of engineered NMs as a valuable source of drug carriers and biocatalyst with critical strategies like pH modification, flocculation, or magnetization for recovery of NMs in the body. Furthermore, this article summarizes the challenges of recycled NMs and advances in integrated technologies such as artificial intelligence, machine learning, in-silico assay, etc. Therefore, potential contribution of NM's life-cycle in the recovery of nanosystems for futuristic developments require consideration in site-specific delivery, reduction of dose, remodeling in breast cancer therapy, wound healing action, antibacterial effect, and for bioremediation to develop ideal nanotherapeutics.

Artificial Intelligence (AI) and Internet of Medical Things (IoMT) Assisted Biomedical Systems for Intelligent Healthcare

Artificial intelligence (AI) is a modern approach based on computer science that develops programs and algorithms to make devices intelligent and efficient for performing tasks that usually require skilled human intelligence. AI involves various subsets, including machine learning (ML), deep learning (DL), conventional neural networks, fuzzy logic, and speech recognition, with unique capabilities and functionalities that can improve the performances of modern medical sciences. Such intelligent systems simplify human intervention in clinical diagnosis, medical imaging, and decision-making ability. In the same era, the Internet of Medical Things (IoMT) emerges as a next-generation bio-analytical tool that combines network-linked biomedical devices with a software application for advancing human health. In this review, we discuss the importance of AI in improving the capabilities of IoMT and point-of-care (POC) devices used in advanced healthcare sectors such as cardiac measurement, cancer diagnosis, and diabetes management. The role of AI in supporting advanced robotic surgeries developed for advanced biomedical applications is also discussed in this article. The position and importance of AI in improving the functionality, detection accuracy, decision-making ability of IoMT devices, and evaluation of associated risks assessment is discussed carefully and critically in this review. This review also encompasses the technological and engineering challenges and prospects for AI-based cloud-integrated personalized IoMT devices for designing efficient POC biomedical systems suitable for next-generation intelligent healthcare.

Network-based drug repurposing: A critical review

New drug development for a disease is a tedious time taking, complex and expensive process. Even if it is done, still the chances for success of newly developed drugs are very low. Modern reports state that repurposing the pre-existing drugs will have more efficient functioning than newly developed drugs. This repurposing process will save time, reduce expenses and provide more success rate. The only limitation for this repurposing is getting a desired pharmacological and characteristic parameter of various drugs from vast data available about a huge number of drugs, their effects, and target mechanisms. This drawback can be avoided by introducing computational methods of analysis. This includes various network analysis types that use various biological processes and relationships with various drugs to make data interpretation a simple process. Some of the data sets now available in standard and simplified forms include gene expression, drug-target interactions, protein networks, electronic health records, clinical trial results, and drug adverse event reports. Integrating various data sets and interpretation methods gives way for a more efficient and easy way to repurpose an exact drug for desired target and effect. In this review, we are going to discuss briefly various computational biological network analysis methods like gene regulatory networks, metabolic networks, protein-protein interaction networks, drug-target interaction networks, drug-disease association networks, drug-drug interaction networks, drug-side effects networks, integrated network-based methods, semantic link networks, and isoform-isoform networks. Along with these, we have also briefly presented limitations, predicting methods, data sets used of various biological networks used of the drug for drug repurposing.

Artificial intelligence to deep learning: machine intelligence approach for drug discovery

Drug designing and development is an important area of research for pharmaceutical companies and chemical scientists. However, low efficacy, off-target delivery, time consumption, and high cost impose a hurdle and challenges that impact drug design and discovery. Further, complex and big data from genomics, proteomics, microarray data, and clinical trials also impose an obstacle in the drug discovery pipeline. Artificial intelligence and machine learning technology play a crucial role in drug discovery and development. In other words, artificial neural networks and deep learning algorithms have modernized the area. Machine learning and deep learning algorithms have been implemented in several drug discovery processes such as peptide synthesis, structure-based virtual screening, ligand-based virtual screening, toxicity prediction, drug monitoring and release, pharmacophore modeling, quantitative structure-activity relationship, drug repositioning, polypharmacology, and physiochemical activity. Evidence from the past strengthens the implementation of artificial intelligence and deep learning in this field. Moreover, novel data mining, curation, and management techniques provided critical support to recently developed modeling algorithms. In summary, artificial intelligence and deep learning advancements provide an excellent opportunity for rational drug design and discovery process, which will eventually impact mankind. The primary concern associated with drug design and development is time consumption and production cost. Further, inefficiency, inaccurate target delivery, and inappropriate dosage are other hurdles that inhibit the process of drug delivery and development. With advancements in technology, computer-aided drug design integrating artificial intelligence algorithms can eliminate the challenges and hurdles of traditional drug design and development. Artificial intelligence is referred to as superset comprising machine learning, whereas machine learning comprises supervised learning, unsupervised learning, and reinforcement learning. Further, deep learning, a subset of machine learning, has been extensively implemented in drug design and development. The artificial neural network, deep neural network, support vector machines, classification and regression, generative adversarial networks, symbolic learning, and meta-learning are examples of the algorithms applied to the drug design and discovery process. Artificial intelligence has been applied to different areas of drug design and development process, such as from peptide synthesis to molecule design, virtual screening to molecular docking, quantitative structure-activity relationship to drug repositioning, protein misfolding to protein-protein interactions, and molecular pathway identification to polypharmacology. Artificial intelligence principles have been applied to the classification of active and inactive, monitoring drug release, pre-clinical and clinical development, primary and secondary drug screening, biomarker development, pharmaceutical manufacturing, bioactivity identification and physiochemical properties, prediction of toxicity, and identification of mode of action.

Evolving scenario of big data and Artificial Intelligence (AI) in drug discovery

The accumulation of massive data in the plethora of Cheminformatics databases has made the role of big data and artificial intelligence (AI) indispensable in drug design. This has necessitated the development of newer algorithms and architectures to mine these databases and fulfil the specific needs of various drug discovery processes such as virtual drug screening, de novo molecule design and discovery in this big data era. The development of deep learning neural networks and their variants with the corresponding increase in chemical data has resulted in a paradigm shift in information mining pertaining to the chemical space. The present review summarizes the role of big data and AI techniques currently being implemented to satisfy the ever-increasing research demands in drug discovery pipelines.

Predicting Successes and Failures of Clinical Trials With Outer Product-Based Convolutional Neural Network

Despite several improvements in the drug development pipeline over the past decade, drug failures due to unexpected adverse effects have rapidly increased at all stages of clinical trials. To improve the success rate of clinical trials, it is necessary to identify potential loser drug candidates that may fail at clinical trials. Therefore, we need to develop reliable models for predicting the outcomes of clinical trials of drug candidates, which have the potential to guide the drug discovery process. In this study, we propose an outer product–based convolutional neural network (OPCNN) model which integrates effectively chemical features of drugs and target-based features. The validation results via 10-fold cross-validations on the dataset used for a data-driven approach PrOCTOR proved that our OPCNN model performs quite well in terms of accuracy, F1-score, Matthews correlation coefficient (MCC), precision, recall, area under the curve (AUC) of the receiver operating characteristic, and area under the precision–recall curve (AUPRC). In particular, the proposed OPCNN model showed the best performance in terms of MCC, which is widely used in biomedicine as a performance metric and is a more reliable statistical measure. Through 10-fold cross-validation experiments, the accuracy of the OPCNN model is as high as 0.9758, F1 score is as high as 0.9868, the MCC reaches 0.8451, the precision is as high as 0.9889, the recall is as high as 0.9893, the AUC is as high as 0.9824, and the AUPRC is as high as 0.9979. The results proved that our OPCNN model shows significantly good prediction performance on outcomes of clinical trials and it can be quite helpful in early drug discovery.

Machine learning-integrated omics for the risk and safety assessment of nanomaterials

With the advancement in nanotechnology, we are experiencing transformation in world order with deep insemination of nanoproducts from basic necessities to advanced electronics, health care products and medicines. Therefore, nanoproducts, however, can have negative side effects and must be strictly monitored to avoid negative outcomes. Future toxicity and safety challenges regarding nanomaterial incorporation into consumer products, including rapid addition of nanomaterials with diverse functionalities and attributes, highlight the limitations of traditional safety evaluation tools. Currently, artificial intelligence and machine learning algorithms are envisioned for enhancing and improving the nano-bio-interaction simulation and modeling, and they extend to the post-marketing surveillance of nanomaterials in the real world. Thus, hyphenation of machine learning with biology and nanomaterials could provide exclusive insights into the perturbations of delicate biological functions after integration with nanomaterials. In this review, we discuss the potential of combining integrative omics with machine learning in profiling nanomaterial safety and risk assessment and provide guidance for regulatory authorities as well.

Artificial intelligence in drug discovery and development

Artificial intelligence-integrated drug discovery and development has accelerated the growth of the pharmaceutical sector, leading to a revolutionary change in the pharma industry. Here, we discuss areas of integration, tools, and techniques utilized in enforcing AI, ongoing challenges, and ways to overcome them.

Machine Learning in Predictive Toxicology: Recent Applications and Future Directions for Classification Models

In recent times, machine learning has become increasingly prominent in predictive toxicology as it has shifted from in vivo studies toward in silico studies. Currently, in vitro methods together with other computational methods such as quantitative structure-activity relationship modeling and absorption, distribution, metabolism, and excretion calculations are being used. An overview of machine learning and its applications in predictive toxicology is presented here, including support vector machines (SVMs), random forest (RF) and decision trees (DTs), neural networks, regression models, naïve Bayes, k-nearest neighbors, and ensemble learning. The recent successes of these machine learning methods in predictive toxicology are summarized, and a comparison of some models used in predictive toxicology is presented. In predictive toxicology, SVMs, RF, and DTs are the dominant machine learning methods due to the characteristics of the data available. Lastly, this review describes the current challenges facing the use of machine learning in predictive toxicology and offers insights into the possible areas of improvement in the field.

Identification and Validation of Carbonic Anhydrase II as the First Target of the Anti-Inflammatory Drug Actarit

Background and purpose: Identifying the macromolecular targets of drug molecules is a fundamental aspect of drug discovery and pharmacology. Several drugs remain without known targets (orphan) despite large-scale in silico and in vitro target prediction efforts. Ligand-centric chemical-similarity-based methods for in silico target prediction have been found to be particularly powerful, but the question remains of whether they are able to discover targets for target-orphan drugs. Experimental Approach: We used one of these in silico methods to carry out a target prediction analysis for two orphan drugs: actarit and malotilate. The top target predicted for each drug was carbonic anhydrase II (CAII). Each drug was therefore quantitatively evaluated for CAII inhibition to validate these two prospective predictions. Key Results: Actarit showed in vitro concentration-dependent inhibition of CAII activity with submicromolar potency (IC₅₀ = 422 nM) whilst no consistent inhibition was observed for malotilate. Among the other 25 targets predicted for actarit, RORγ (RAR-related orphan receptor-gamma) is promising in that it is strongly related to actarit’s indication, rheumatoid arthritis (RA). Conclusion and Implications: This study is a proof-of-concept of the utility of MolTarPred for the fast and cost-effective identification of targets of orphan drugs. Furthermore, the mechanism of action of actarit as an anti-RA agent can now be re-examined from a CAII-inhibitor perspective, given existing relationships between this target and RA. Moreover, the confirmed CAII-actarit association supports investigating the repositioning of actarit on other CAII-linked indications (e.g., hypertension, epilepsy, migraine, anemia and bone, eye and cardiac disorders).

Machine Learning for Identifying Medication-Associated Acute Kidney Injury

One of the prominent problems in clinical medicine is medication-induced acute kidney injury (AKI). Avoiding this problem can prevent patient harm and reduce healthcare expenditures. Several researches have been conducted to identify AKI-associated medications using statistical, data mining, and machine learning techniques. However, these studies are limited to assessing the impact of known nephrotoxic medications and do not comprehensively explore the relationship between medication combinations and AKI. In this paper, we present a population-based retrospective cohort study that employs automated data analysis techniques to identify medications and medication combinations that are associated with a higher risk of AKI. By integrating multivariable logistic regression, frequent itemset mining, and stratified analysis, this study is designed to explore the complex relationships between medications and AKI in such a way that has never been attempted before. Through an analysis of prescription records of one million older patients stored in the healthcare administrative dataset at ICES (an independent, non-profit, world-leading research organization that uses population-based health and social data to produce knowledge on a broad range of healthcare issues), we identified 55 AKI-associated medications among 595 distinct medications and 78 AKI-associated medication combinations among 7748 frequent medication combinations. In addition, through a stratified analysis, we identified 37 cases where a particular medication was associated with increasing the risk of AKI when used with another medication. We have shown that our results are consistent with previous studies through consultation with a nephrologist and an electronic literature search. This research demonstrates how automated analysis techniques can be used to accomplish data-driven tasks using massive clinical datasets.

Multiple Regression Analysis and Frequent Itemset Mining of Electronic Medical Records: A Visual Analytics Approach Using VISA_M3R3

Medication-induced acute kidney injury (AKI) is a well-known problem in clinical medicine. This paper reports the first development of a visual analytics (VA) system that examines how different medications associate with AKI. In this paper, we introduce and describe VISA_M3R3, a VA system designed to assist healthcare researchers in identifying medications and medication combinations that associate with a higher risk of AKI using electronic medical records (EMRs). By integrating multiple regression models, frequent itemset mining, data visualization, and human-data interaction mechanisms, VISA_M3R3 allows users to explore complex relationships between medications and AKI in such a way that would be difficult or sometimes even impossible without the help of a VA system. Through an analysis of 595 medications using VISA_M3R3, we have identified 55 AKI-inducing medications, 24,212 frequent medication groups, and 78 medication groups that are associated with AKI. The purpose of this paper is to demonstrate the usefulness of VISA_M3R3 in the investigation of medication-induced AKI in particular and other clinical problems in general. Furthermore, this research highlights what needs to be considered in the future when designing VA systems that are intended to support gaining novel and deep insights into massive existing EMRs.

Artificial Intelligence for Drug Toxicity and Safety

Interventional pharmacology is one of medicine's most potent weapons against disease. These drugs, however, can result in damaging side effects and must be closely monitored. Pharmacovigilance is the field of science that monitors, detects, and prevents adverse drug reactions (ADRs). Safety efforts begin during the development process, using in vivo and in vitro studies, continue through clinical trials, and extend to postmarketing surveillance of ADRs in real-world populations. Future toxicity and safety challenges, including increased polypharmacy and patient diversity, stress the limits of these traditional tools. Massive amounts of newly available data present an opportunity for using artificial intelligence (AI) and machine learning to improve drug safety science. Here, we explore recent advances as applied to preclinical drug safety and postmarketing surveillance with a specific focus on machine and deep learning (DL) approaches.