Digital pharmacological twins: Bridging multi-scale modelling and artificial intelligence for precision medicine: The...

The advent of digital twins in pharmacology presents transformative potential for precision medicine, enabling personalized treatment optimization through dynamic computational simulations of drug interactions at molecular, cellular, and patient levels. These advanced virtual replicas of a patient's biological system are designed to predict individual therapeutic responses with high fidelity, thereby moving beyond the one-size-fits-all paradigm. This paper explores the concept of digital pharmacological twins, detailing how they can integrate heterogeneous data, including multi-omic, pharmacokinetic, pharmacodynamic, clinical, and environmental information, and employing a synergy of advanced mechanistic and machine learning models. Using illustrative examples from ongoing international initiatives, this work highlights the methodological frameworks necessary for developing and validating such comprehensive predictive tools. We underscore the critical importance of model interoperability, robust data integration strategies, and rigorous validation to ensure clinical utility. Ultimately, digital pharmacological twins promise to enhance therapeutic efficacy, minimize adverse drug reactions, and accelerate the translation of pharmacological science into tangible patient benefits.