Are We Considering All the Potential Drug-Drug Interactions in Women's Reproductive Health? A Predictive Model Approach

Autores de IIS La Fe

• Pablo García Acero

  Autor

• Ismael Henarejos Castillo

  Autor

• Francisco José Sanz López

  Autor

• Patricia Sebastián León

  Autor

• Antonio Parraga Leo

  Autor

• Juan Antonio García Velasco

  Autor

• Patricia Díaz Gimeno

  Autor

Grupos

• Biomarcadores, Medicina Genómica, Estadística y Análisis masivo de datos en Reproducción humana asistida

• Endocrinología Reproductiva e Infertilidad

• Medicina Fetal y Reproductiva

Abstract

Background: Drug-drug interactions (DDIs) may occur when two or more drugs are taken together, leading to undesired side effects or potential synergistic effects. Most clinical effects of drug combinations have not been assessed in clinical trials. Therefore, predicting DDIs can provide better patient management, avoid drug combinations that can negatively affect patient care, and exploit potential synergistic combinations to improve current therapies in women's healthcare. Methods: A DDI prediction model was built to describe relevant drug combinations affecting reproductive treatments. Approved drug features (chemical structure of drugs, side effects, targets, enzymes, carriers and transporters, pathways, protein-protein interactions, and interaction profile fingerprints) were obtained. A unified predictive score revealed unknown DDIs between reproductive and commonly used drugs and their associated clinical effects on reproductive health. The performance of the prediction model was validated using known DDIs. Results: This prediction model accurately predicted known interactions (AUROC = 0.9876) and identified 2991 new DDIs between 192 drugs used in different female reproductive conditions and other drugs used to treat unrelated conditions. These DDIs included 836 between drugs used for in vitro fertilization. Most new DDIs involved estradiol, acetaminophen, bupivacaine, risperidone, and follitropin. Follitropin, bupivacaine, and gonadorelin had the highest discovery rate (42%, 32%, and 25%, respectively). Some were expected to improve current therapies (n = 23), while others would cause harmful effects (n = 11). We also predicted twelve DDIs between oral contraceptives and HIV drugs that could compromise their efficacy. Conclusions: These results show the importance of DDI studies aimed at identifying those that might compromise or improve their efficacy, which could lead to personalizing female reproductive therapies.

Keywords

• drug-drug interactions; side effects; female reproductive therapies; polypharmacology; gynecology; pharmacotherapy