title: Pharmacointeraction network models predict unknown drug-drug interactions.
abstract: Drug-drug interactions (DDIs) can lead to serious and potentially lethal adverse events. In recent years, several drugs have been withdrawn from the market due to interaction-related adverse events (AEs). Current methods for detecting DDIs rely on the accumulation of sufficient clinical evidence in the post-market stage - a lengthy process that often takes years, during which time numerous patients may suffer from the adverse effects of the DDI. Detection methods are further hindered by the extremely large combinatoric space of possible drug-drug-AE combinations. There is therefore a practical need for predictive tools that can identify potential DDIs years in advance, enabling drug safety professionals to better prioritize their limited investigative resources and take appropriate regulatory action. To meet this need, we describe Predictive Pharmacointeraction Networks (PPINs) - a novel approach that predicts unknown DDIs by exploiting the network structure of all known DDIs, together with other intrinsic and taxonomic properties of drugs and AEs. We constructed an 856-drug DDI network from a 2009 snapshot of a widely-used drug safety database, and used it to develop PPIN models for predicting future DDIs. We compared the DDIs predicted based solely on these 2009 data, with newly reported DDIs that appeared in a 2012 snapshot of the same database. Using a standard multivariate approach to combine predictors, the PPIN model achieved an AUROC (area under the receiver operating characteristic curve) of 0.81 with a sensitivity of 48% given a specificity of 90%. An analysis of DDIs by severity level revealed that the model was most effective for predicting "contraindicated" DDIs (AUROC = 0.92) and less effective for "minor" DDIs (AUROC = 0.63). These results indicate that network based methods can be useful for predicting unknown drug-drug interactions.
authors.affiliation: Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA. aurel.cami@childrens.harvard.edu
authors.forename: Aurel
authors.initials: A
authors.lastname: Cami
authors.forename: Shannon
authors.initials: S
authors.lastname: Manzi
authors.forename: Alana
authors.initials: A
authors.lastname: Arnold
authors.forename: Ben Y
authors.initials: BY
authors.lastname: Reis
mesh_terms: D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008962:Models, Theoretical; D012372:ROC Curve