A translational bioinformatics approach to elucidate and mitigate polypharmacy induced adverse drug reactions

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PROJECT SUMMARY This proposal for a mentored career development award consists of a training and research plan to facilitate Dr. Zackary Falls' transition to an independent investigator focusing on translational bioinformatics for patient tailored predictive analytics related to opioid addiction severity. The opioid epidemic is a major concern in the United States that is exacerbated due to the high prevalence of prescribing two or more drugs to patients living with opioid use disorder, which increases the likelihood of adverse drug reactions (ADRs) occurring in these patients. Knowing and predicting drug–drug interactions (DDIs) and resulting ADRs is critical for the safety of patients, but ADR prediction software tools used in clinical practice have many limitations. Firstly, most DDI databases used in these software tools are incomplete because they incorporate only pair–wise DDIs. Additionally, most software tools do not incorporate biological mechanism of action information for the drugs and omit relevant patient– specific clinical data such as diagnoses, tobacco use, etc. Dr. Falls aims to exceed the efficacy of these software with the creation of embedded representations for each patient's prescription profile, leveraging both drug–protein interaction knowledge about the prescription drugs and patient level clinical data pertaining to polypharmacy and ADRs. The specific aims of this research are to predict and validate novel off–target proteins for opioids and other commonly co–prescribed medications (Aim 1), extract polypharmacy interactions and ADR relationships from electronic health records of opioid prescription patients (Aim 2), and design a patient personalized software that uses deep–learning architecture to predict severe ADRs caused by opioid related polypharmacy interactions (Aim 3) to be integrated with clinical decision support systems for the benefit of patients and clinicians. The ap- plicant has detailed a rigorous plan containing three career development goals for gaining the skills and expertise to accomplish his research aims. These goals include: Goal 1. Gain knowledge in addiction research and phar- macology as it relates to opioid use, Goal 2. Acquire advanced statistical analysis skills for clinical datasets, and Goal 3. Increase understanding of graph theory and knowledge graph implementation. The team of mentors and collaborators that has been assembled by Dr. Falls, including Prof. Ram Samudrala as primary mentor, perfectly accounts for expertise in research areas that the applicant will be investigating and have knowledge in domains that complement his own understandings to aid in the career development aspect of this proposal. Dr. Falls has the aptitude, creativity, and perseverance to become an excellent researcher. The support of this K01, guidance from his terrific team of mentors and collaborators, and the influence of a rich research environment will enable him to further develop his skills and knowledge. He will surely accomplish all of his career development goals and research aims, become a successful independent investigator, and flourish in his career.