Next-generation experimental and computational strategies for drug-drug interaction prophecy

Drug-drug interactions (DDIs) pose significant challenges in pharmacotherapy, affecting drug efficacy and safety. Traditional in vitro and in vivo models often fail to accurately predict clinically relevant DDIs, necessitating the development of advanced testing platforms. This review explores cutting-edge in vitro and in vivo systems, including chimeric mice with humanized livers, clustered regularly interspaced short palindromic repeats-CRISPR-associated animal models, liver microphysiological systems, and 3-dimensional spheroids and organoids that enhance the assessment of DDIs. These models enable the precise evaluation of drug metabolism, enzyme induction/inhibition, and transporter-mediated interactions under physiologically relevant conditions. In addition, we discuss the latest advancements in predictive modeling techniques for DDIs, focusing on physiologically based pharmacokinetic models and machine learning approaches. Physiologically based pharmacokinetic models integrate drug-specific and system-specific parameters to simulate DDIs dynamically, bridging the gap between preclinical and clinical findings. Machine learning-based predictive tools use vast datasets to identify complex interaction patterns, improving DDI risk assessment in early drug development. By integrating these novel experimental and computational approaches, researchers can achieve more accurate, quantitative DDI predictions, facilitating safer drug design and regulatory decision-making. The review highlights these emerging methodologies, emphasizing the need for continued refinement to enhance their predictive power and translational relevance. Future research should focus on optimizing hybrid strategies that combine mechanistic and data-driven models to achieve robust, clinically meaningful DDI assessments. SIGNIFICANCE STATEMENT: This review showcases advanced experimental and computational tools to improve drug-drug interaction prediction. These innovations enhance drug-drug interaction accuracy, support safer drug development, aid regulatory and clinical decisions, reduce adverse reactions, and optimize patient care.