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Signal Detection

Standard pharmacovigilance was designed for single-drug safety. TrialVyx was built for the polypharmacy reality.

When 40% of post-market adverse events involve three or more concurrent medications, pairwise ROR/PRR analysis leaves the majority of the drug-combination signal space structurally unexamined. That's not a query design problem — it's a method design problem.

40% post-market AEs involve 3+ drugs
N-drug graph analysis (N ≥ 2)
60–120d earlier than pairwise methods

The DDI Detection Gap

Why pairwise ROR/PRR misses multi-drug interactions

Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) were developed for an era of simpler drug regimens. They examine the statistical relationship between a single drug and a single adverse event term — a method that works adequately for single-agent monitoring.

In polypharmacy — the clinical reality for most elderly and chronic disease patients — the interaction isn't between drug A and adverse event X. It's between the combination of drugs A, B, and C and the resulting adverse event profile that none of them would produce individually. Pairwise methods cannot detect this class of signal.

TrialVyx constructs N-drug interaction graphs — capturing triads, tetrads, and higher-order combinations — and propagates detection probability across the full drug-AE co-occurrence network.

Pairwise ROR/PRR coverage
~60%

Drug pairs only — N=2 combinations

TrialVyx graph coverage
N ≥ 2

All N-drug combinations including triads and tetrads

Methodology

Graph-based DDI analysis

The detection model constructs a network where indirect drug relationships become visible.

Node construction: Each unique drug (by INN) and each adverse event preferred term (MedDRA PT) becomes a node. Nodes accumulate report counts, temporal data, and seriousness weights from the ingested ICSR corpus.

Edge weighting: Edges between drug nodes encode co-prescription frequency — how often those drugs appear together in the same ICSR report. Edge weight increases with co-occurrence and is recency-discounted to reflect current prescribing patterns.

Propagation: Bayesian belief propagation flows detection evidence through the graph. A new adverse event report doesn't just update the direct drug-AE edge — it propagates probability updates to all connected drug combinations, revealing indirect interaction chains that pairwise analysis cannot detect.

Output: Signals are scored by IC (Information Component) value, trend velocity, and clinical severity. Multi-drug combinations scoring above the Investigate threshold surface as signal briefs for your PV team.

Signal Classes

Signal classes TrialVyx detects

Class examples from retrospective FAERS analysis. Drug names are therapeutic class descriptors, not specific compounds.

Class example 01 — Cardiovascular Statin + immunosuppressant + proton-pump inhibitor triad — QT-prolongation cluster

Co-prescription of statins with calcineurin inhibitors and PPIs creates a metabolic pathway interaction. Individual pairwise ROR for any two agents shows unremarkable values. The triad's combined CYP3A4 burden and QT-prolongation potential only becomes visible in graph analysis across concurrent prescriptions.

Detected via TrialVyx methodology in retrospective FAERS analysis. Class example only.
Class example 02 — Hematology/Geriatric NSAID + anticoagulant + SSRI — bleeding signal emerging in elderly co-prescriptions

Each agent has known individual bleeding risk. Standard monitoring tracks each pair. The triad's combined platelet inhibition and anticoagulation burden creates a signal that exceeds what any pairwise analysis would project — particularly concentrated in geriatric FAERS reporter populations with high co-prescription rates.

Detected via TrialVyx methodology in retrospective FAERS analysis. Class example only.
Class example 03 — Infectious Disease Antifungal + HIV therapy + cardiac drug — metabolic pathway signal

Azole antifungals create significant CYP3A4 inhibition. When combined with certain HIV protease inhibitors and QT-extending cardiac agents, the metabolic interaction creates a cumulative drug exposure risk that standard monitoring of any individual pair fails to surface until adverse event accumulation is substantial.

Detected via TrialVyx methodology in retrospective FAERS analysis. Class example only.
Class example 04 — Oncology supportive care Oncology supportive care combination — hepatotoxicity cluster

Multiple agents in oncology supportive care regimens carry hepatotoxicity signals individually below reporting thresholds. Combined administration in the FAERS record reveals a hepatotoxicity cluster — visible in graph analysis of the co-prescription network but not in any individual pairwise statistical calculation.

Detected via TrialVyx methodology in retrospective FAERS analysis. Class example only.

Lead Time Comparison

Detection capability: TrialVyx vs. ROR/PRR/BCPNN

Capability TrialVyx Standard ROR/PRR
Earliest detectable signal 60–120 days before statistical threshold At or after statistical significance threshold
Multi-drug (N ≥ 3) detection Yes — N-drug graph analysis No — pairwise analysis only
Regulatory-ready output MedDRA-coded, audit trail included Requires separate documentation step
Indirect interaction chains Yes — Bayesian propagation across graph No — direct association only
FAERS corpus coverage Full corpus, all report types Depends on query design

Configure N-drug signal monitoring for your compound portfolio.

TrialVyx is configured per compound portfolio — we set the drug list, therapeutic area context, and detection thresholds specific to your post-market monitoring obligations. Request a methodology briefing to see how the graph model applies to your compounds.