Artificial Intelligence and Data Mining for the Pharmacovigilance of Drug-Drug Interactions

Despite increasing mechanistic understanding, undetected and underrecognized drug-drug interactions (DDIs) persist. This elusiveness relates to an interwoven complexity of increasing polypharmacy, multiplex mechanistic pathways, and human biological individuality. This persistent elusiveness motivates development of artificial intelligence (AI)-based approaches to enhancing DDI detection and prediction capabilities. The literature is vast and roughly divided into "prediction" and "detection." The former relatively emphasizes biological and chemical knowledge bases, drug development, new drugs, and beneficial interactions, whereas the latter utilizes more traditional sources such as spontaneous reports, claims data, and electronic health records to detect novel adverse DDIs with authorized drugs. However, it is not a bright line, either nominally or in practice, and both are in scope for pharmacovigilance supporting signal detection but also signal refinement and evaluation, by providing data-based mechanistic arguments for/against DDI signals. The wide array of intricate and elegant methods has expanded the pharmacovigilance tool kit. How much they add to real prospective pharmacovigilance, reduce the public health impact of DDIs, and at what cost in terms of false alarms amplified by automation bias and its sequelae are open questions.