Saudi Pharmaceutical Journal最新文献

{"title":"Comparison of renal function parameters and acute kidney injury incidence between vancomycin monotherapy and vancomycin-fosfomycin combination therapy in patients: a propensity score-matched analysis.","authors":"Lan Chen, Xiaoqing Huang, Yaqian Yan, Dandan Wang, Guoping Liu, Shuwen Huang, Qingqing Li, Bin Yang, Yue Qiu","doi":"10.1007/s44446-026-00065-3","DOIUrl":"10.1007/s44446-026-00065-3","url":null,"abstract":"<p><p>Vancomycin (VAN) is a first-line agent for methicillin-resistant Staphylococcus aureus (MRSA) infections, but it poses nephrotoxicity risks. While VAN-fosfomycin (FOS) combination shows synergistic efficacy and lower mutant prevention concentrations, its renoprotective effects compared to VAN alone remain unclear. This study aims to directly compare renal function parameters and acute kidney injury incidence between VAN monotherapy and VAN + FOS combination therapy. After propensity score matching of the initial 156 patients, 76 individuals were included in the final analysis; 38 were assigned to the vancomycin monotherapy group and 38 in the VAN + FOS combination group. Renal function parameters were recorded at 48 h and 72 h post-treatment, and the incidence of acute kidney injury (AKI) was compared between the two groups. Univariate analyses were performed to identify baseline factors associated with AKI. The VAN + FOS group had a significantly lower incidence of AKI compared to the VAN-alone group (5.26% vs. 21.05%, P = 0.04). Due to the limited number of AKI cases, multivariate adjustment was not possible. Univariate analysis revealed significant associations between AKI incidence and FOS combination therapy, age, and vancomycin trough concentration (P = 0.04, P = 0.00, and P = 0.02, respectively). These findings warrant validation in larger, prospective studies. Fosfomycin adjunct therapy was associated with a lower incidence of vancomycin-induced AKI. However, these associations should be interpreted cautiously and require validation in larger cohorts.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities and mortality in colistin-resistant gram-negative infections among hospitalized patients in Qassim, Saudi Arabia.","authors":"Masaad Saeed Almutairi, Mohammed Albulaihed, Faisal Almutairi, Yasser Alsuhaibani, Mohammed Alkathlan, Faris S Alnezary, Abdulrahman Saleh Aljamhan, Afaf Ibrahim Alresheedi, Zikria Saleem, Omar A Almohammed","doi":"10.1007/s44446-026-00069-z","DOIUrl":"10.1007/s44446-026-00069-z","url":null,"abstract":"<p><p>Colistin has served as a last-resort agent against multidrug-resistant Gram-negative bacilli (MDR-GNB). However, the emergence of resistance has substantially eroded its therapeutic value, particularly among hospitalized patients. Evidence regarding the clinical outcomes of colistin-resistant infections in Saudi Arabia, however, remains scarce. This study aimed at assessing the clinical characteristics and outcomes of colistin-resistant bacterial infections among hospitalized patients in the Qassim region. We conducted a single-center retrospective observational study at King Fahad Specialist Hospital, Qassim, Saudi Arabia, reviewing the records of hospitalized patients with colistin-resistant infections between 2019 to 2023. Demographic, clinical, microbiological, therapeutic, and outcome data were retrieved from both electronic and paper health records. Eighty-five patients (mean age, 65.8 years; 60% male) with eighty-five colistin-resistant isolates were identified. Enterobacterales predominated (85.9%), followed by Pseudomonas aeruginosa (9.4%) and Acinetobacter baumannii (4.7%). All isolates showed extensive colistin resistance (100% in Acinetobacter and Pseudomonas, 82.8% in Enterobacterales), acknowledging the small number of non-Enterobacterales isolates. Limited sensitivity to cephalosporins and carbapenems, underscoring the therapeutic challenge of MDR-GNB. Meropenem (39.7%) and tigecycline (15.1%) were the most frequently prescribed agents, whereas combination therapy was employed in 16.6% of cases. The overall in-hospital mortality was 54.1% (95% CI: 43.0-65.0), with substantially higher mortality among patients admitted to the ICU (70.8%, 95% CI: 55.9-83.0) compared with those managed in non-ICU settings (32.4%, 95% CI: 18.0-49.8). After adjustment for clinical indicators, ICU admission was independently associated with increased mortality. Colistin-resistant Gram-negative infections hospitalized patients were characterized by severely limited therapeutic options, substantial reliance on carbapenems and tigecycline, and high observed mortality. These observations underscore the need for strengthened antimicrobial stewardship, improved availability of rapid diagnostic tools, and expanded access to newer therapeutic agents. In the absence of such measures, the burden of colistin resistance is likely to persist in hospital settings, including patients requiring intensive care.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery of a novel VEGFR2 inhibitor using integrated structure-based docking study and functional validation: potential applications in targeted cancer therapy.","authors":"Hussam Albassam, Saad Alobid, Faris Almutairi, Faisal Altowairqi","doi":"10.1007/s44446-026-00072-4","DOIUrl":"10.1007/s44446-026-00072-4","url":null,"abstract":"<p><p>Cancer remains a predominant cause of mortality worldwide, with conventional therapies often limited by adverse side effects and the development of drug resistance. Targeting receptor tyrosine kinases (RTKs), especially vascular endothelial growth factor receptor 2 (VEGFR2), presents a viable strategy due to its pivotal role in tumor angiogenesis. This study employed an integrative approach combining structure-based docking study, kinase inhibition assays, and cytotoxicity evaluations to identify novel VEGFR2 inhibitors. A Protein Kinase Diversity Set library comprising over 2,000 compounds was screened via molecular docking against the VEGFR2 crystal structure. The highest-ranking candidates were subjected to detailed binding interaction analyses. Cytotoxicity assays demonstrated significant anti-proliferative effects in VEGFR2-overexpressing U87 cells, while enzymatic assays confirmed one novel compound's potency in inhibiting VEGFR2 kinase activity. Redocking simulations focusing on the receptor's active site ensured comprehensive conformational exploration of ligand binding modes. Our results identify a promising lead compound as a novel inhibitor of VEGFR2, with potential applicability as an anti-angiogenic and anticancer therapeutic agent, warranting further optimization.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essence of toxicology research to Saudi Arabia Vision 2030 and beyond: Current state and future perspectives.","authors":"Nasser B Alsaleh","doi":"10.1007/s44446-025-00060-0","DOIUrl":"10.1007/s44446-025-00060-0","url":null,"abstract":"<p><p>The Kingdom of Saudi Arabia has been making significant progress as part of its Vision 2030 to diversify its economy and reduce dependence on fossil fuels. Key components of this transformation include the development of a robust research and development (R&D) ecosystem and biotechnology-based industry. The Kingdom has recently formed the Research, Development and Innovation Authority (RDIA) to regulate and fund research with Health and Wellness being among its top priorities, and the Saudi National Institute of Health (SNIH) to support translational health research and clinical trials. In addition, the country has launched its National Biotechnology Strategy with a bold goal of becoming a biotechnology hub in the region by 2030 and globally by 2040. Toxicology research is central to these transformations. Historically, it has served as a cornerstone to biomedical and healthcare R&D. Today, with advancements in materials science and the integration of multiple technologies (e.g., biotechnology, nanotechnology, artificial intelligence, etc.) across the different industry sectors, it has become more critical than ever to assess safety early in the development process. In this editorial, we discuss the essence of toxicology research in realizing the country's ambitious goals of Vision 2030 and beyond, particularly in the development of the healthcare and biomedical R&D sectors and advancing a biotechnology-based industry. We first provide an overview of the current state of toxicology research and discuss its critical role in advancing the goals of Vision 2030. Finally, we discuss future directions for harnessing toxicology research towards achieving the country's ambitious goals.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"7"},"PeriodicalIF":4.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacogenomics knowledge, attitudes, and perceptions among pharmacists in the Asir Region, Saudi Arabia: a cross-sectional analysis.","authors":"Saud Alqahtani, Taha Alqahtani, Krishnaraju Venkatesan, Vigneshwaran Easwaran, Kousalya Prabahar, Premalatha Paulsamy, Rehab Ahmed, Nizar Sirag, Durgaramani Sivadasan, Hassabelrasoul Elfadil, Nouf M Alharthi","doi":"10.1007/s44446-025-00061-z","DOIUrl":"10.1007/s44446-025-00061-z","url":null,"abstract":"<p><p>As personalized medicine progresses in Saudi Arabia, pharmacists endure a central role in pharmacogenomics (PGx) implementation. This cross-sectional study weighed the knowledge, attitudes, and perceptions (KAP) of pharmacists in the Asir region regarding PGx, a region with limited published data. A total of 209 pharmacists took part, the majority of whom were male (68.4%) and aged 18-39 years (96.2%). Results revealed that 71.3% of pharmacists displayed poor knowledge, whereas positive attitudes (90.9%) and perceptions (87.6%) were widely expressed. Significant associations developed between knowledge and attitude (p = 0.015) and between knowledge and perception (p = 0.036). A moderate correlation was also reflected between attitude and perception (p < 0.001, Cramér's V = 0.44). Logistic regression showed that pharmacists lacking previous PGx training (OR = 0.257, p < 0.001) or lacking experience with genetic conditions (OR = 0.389, p = 0.022) were significantly less likely to demonstrate good knowledge. Regardless of evident knowledge gaps, pharmacists showed a strong willingness to integrate PGx into clinical practice. These findings highlight an imperative need for structured PGx training programs, integration of PGx into pharmacy curricula, ongoing professional development workshops, and institutional strategies to support operative PGx adoption in healthcare settings across the Asir region and Saudi Arabia.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"6"},"PeriodicalIF":4.3,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanocarrier-mediated CRISPR-Cas delivery: a novel approach against antibiotic-resistant superbugs.","authors":"Fawaz M Almufarriji","doi":"10.1007/s44446-026-00064-4","DOIUrl":"10.1007/s44446-026-00064-4","url":null,"abstract":"<p><p>Antibiotic resistance (ABR) is a leading cause of death and a major public health threat globally. Without appropriate interventions, annual ABR-associated deaths have been projected to reach 10 million by 2050 worldwide. Hence, it is critical to develop novel therapeutic interventions that would be able to tackle ABR by targeting mainly the pathogenic microbes, while lessening harm to beneficial microbes. There is an increasing research interest in CRISPR-Cas (CC) systems owing to their potential in controlling and preventing horizontal gene transfer and spread of antibiotic resistance. In addition, CC systems offer several advantages, including high efficiency, rapid turnaround time, low cost, and easy design, which allow these systems to effectively and precisely target antibiotic-resistant bacteria. CRISPR-based gene therapy offers numerous benefits; however, the major limitation in clinical translation is the safe and effective delivery of CRISPR components to target organs or cells, thus hindering its potential in therapeutic interventions. Nanocarriers (NCs) can help the CC systems to overcome their off-target effects by precisely delivering the systems to the target cells. NCs can also be engineered for target site release, payload protection, and high specificity, which can further ensure delivery of the components of CC in the target cells or regions without harming surrounding tissues. This review summarizes the principles and mechanisms of CC systems, highlights their applications against antibiotic-resistant bacteria, and discusses emerging nanocarrier-based delivery strategies that may enhance the clinical utility of CRISPR-Cas technologies in managing ABR.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"5"},"PeriodicalIF":4.3,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empagliflozin improves renal injury of diabetic nephropathy complicated with hyperuricemia through AMPK by promoting autophagy and inhibiting apoptosis.","authors":"Zhiqin Zhang, Yanmei Xu, Chuanwen Xu, Qi Gao, Xiaoyan Wu, Ting Wu","doi":"10.1007/s44446-025-00054-y","DOIUrl":"10.1007/s44446-025-00054-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate how empagliflozin alleviates renal injury in diabetic nephropathy with hyperuricemia by activating AMPK and regulating autophagy and apoptosis.</p><p><strong>Methods: </strong>This study incorporated clinical renal tissue samples, diabetic-hyperuricemic mouse models, and HK-2 tubular epithelial cells to investigate the effects of empagliflozin on renal injury. Diabetic nephropathy with hyperuricemia was modeled using streptozotocin and high-fat diet in mice, while HK-2 cells were treated with high glucose and uric acid in vitro. Empagliflozin was administered with or without AMPK inhibition to assess its regulatory role.</p><p><strong>Results: </strong>In renal tissues and HK-2 cells under high-glucose and high-uric acid conditions, Empagliflozin treatment increased LC3 expression and AMPK phosphorylation, and decreased cleaved caspase-3 levels. In diabetic-hyperuricemic mice, Empagliflozin also ameliorated fibrosis and reduced pathological damage. These effects were reversed upon co-treatment with Compound C, an AMPK inhibitor, which suppressed autophagy activation and restored apoptotic signaling. These results indicate that Empagliflozin exerts reno-protective effects by activating AMPK to promote autophagy and inhibit apoptosis, and that AMPK plays a central mechanistic role in mediating these effects.</p><p><strong>Conclusion: </strong>Empagliflozin alleviates renal injury in diabetic nephropathy with hyperuricemia by activating AMPK, promoting autophagy, and inhibiting apoptosis, suggesting its potential therapeutic value in managing this complication.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"4"},"PeriodicalIF":4.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of drug eruption associated with the use of tetracyclines, macrolides, and fluoroquinolones: real-world evidence from a pharmacovigilance study utilizing the FDA adverse event reporting system.","authors":"Thamir M Alshammari","doi":"10.1007/s44446-025-00058-8","DOIUrl":"10.1007/s44446-025-00058-8","url":null,"abstract":"<p><p>Recently, concerns regarding the risk of drug eruption associated with the use of tetracyclines were raised by the United States Food and Drug Administration (U.S. FDA). Therefore, it is necessary to reevaluate this risk. This study aimed to quantify the signal of drug eruption associated with the use of tetracyclines. Also, the signal of drug eruption with the use of two other antimicrobial drugs-macrolides and fluoroquinolones-was investigated for comparison. A pharmacovigilance case/noncase study was conducted using the U.S. FDA Adverse Event Reporting System (FAERS). Reports of drug eruptions using the preferred term were retrieved from the database from 2020-2025 quarter 1. The associations between the risk of drug eruption and the three antibiotic classes were quantified using disproportionality analysis utilizing both Bayesian and traditional statistical analyses, including the reporting odds ratio (ROR), proportional reporting ratio (PRR), empirical Bayes geometric mean (EBGM) and information component (IC). All three antibiotic classes were significantly associated with the risk of drug eruption. However, compared with fluoroquinolones and macrolides, tetracyclines were more strongly associated with drug eruption. Disproportionality analysis revealed that the ROR for tetracycline was 6.65 (95% confidence interval (CI), 4.00-11.09) in 2020; in 2024, it was 30.75 (95% CI, 24.46-38.67). For macrolides, the RORs were 2.16 (95% CI, 1.20-3.92) and 10.12 (95% CI, 7.16-14.31) in 2020 and 2024, respectively. The RORs for fluoroquinolones were 4.57 (95% CI, 3.20-6.52) in 2020 and 2.27 (95% CI, 1.31-3.92) in 2024. Males were predominant in the tetracycline group (74%), and females were predominant in the macrolide group (56%). Approximately 41% and 40% of patients in the fluoroquinolone and macrolide classes, respectively, were hospitalized. All three antibiotic classes were associated with the signal of drug eruption. The signal of drug eruption occurred across all age groups with all three antibiotics. Also, the signal has affected both males and females across the years studied. However, there is no specific pattern for the signal.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"3"},"PeriodicalIF":4.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the PI3K/AKT/mTOR signaling pathway in prostate cancer: Molecular dysregulation, therapeutic advances, and future directions.","authors":"Saad Alobid","doi":"10.1007/s44446-025-00056-w","DOIUrl":"10.1007/s44446-025-00056-w","url":null,"abstract":"<p><p>Prostate cancer (PCa) is among the most common malignancies and remains a leading cause of cancer-related mortality in men worldwide. One of the main drivers is the dysregulation of the downstream signalling machinery. The PI3K, AKT, and mTOR signalling pathways play a pivotal role in cellular sustenance, growth, metabolism, and proliferation. In prostate cancer this pathway is generally altered due to the mutation or deletion of the PTEN (phosphatase and tensin homolog) gene and unnecessary activities of some components of PI3K, AKT, or mTOR. Extracellular communication of the androgen receptor (AR) with a wide array of oncogenic signatures is a primary evasion mechanism of cancer therapy and metastasis. This review focuses on the structure and function of the PI3K/AKT/mTOR pathway to better understand its role in prostate tumor biology. Furthermore, current therapeutic strategies that combinatorically target individual components of this pathway, such as allosteric and ATP-competitive AKT inhibitors, isoform-selective PI3K inhibitors, first- and second-generation mTOR inhibitors, are under consideration. The study particularly focuses on the combined use of immunotherapy (checkpoint inhibitors), chemotherapy (docetaxel), and androgen deprivation therapy (ADT), which are designed to break through the resistance-generating mechanisms and increase clinical efficacy. Overall, the findings support the need to conduct comprehensive preclinical and clinical studies on these alternative treatment regimens, and the eventual goal is to develop new treatment options for prostate cancer. The evidence of the pathway-specific therapy approach for the treatment of prostate cancer in recent clinical trials still failed to give a conclusive result. The current discussion also investigates the emerging areas of focus and perfection of combination regimens. The combination of all these developments makes it clear that the PI3K/AKT/mTOR signalling pathway is a key strategic point for developing therapeutics.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"2"},"PeriodicalIF":4.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare.","authors":"Sitah Alharthi","doi":"10.1007/s44446-025-00055-x","DOIUrl":"10.1007/s44446-025-00055-x","url":null,"abstract":"<p><p>In silico twins (ISTs) are emerging as a transformative paradigm in precision medicine, offering dynamic, high-fidelity representations of individual patients through real-time integration of multimodal data. In this work, we define an in silico twin (IST) as a high-fidelity, artificial intelligence(AI)-augmented computational replica of an individual's biological systems that integrates mechanistic modeling (e.g., PBPK, QSP) with patient-specific data streams to simulate, predict, and optimize therapeutic outcomes in real time. By combining AI, physiological and biomechanical modeling, and advanced simulation engines, these systems enable continuous monitoring, predictive diagnostics, and personalized treatment planning. Unlike conventional digital tools, ISTs provide iterative, adaptive simulations that evolve with patient states, fostering a shift from reactive to proactive healthcare. This review explores the technological foundations underpinning ISTs -including machine learning architectures, multi-scale physiological modeling, data integration, and cloud-edge infrastructure- and maps their clinical applications across the patient care continuum. We also distinguish ISTs from digital twins, virtual patients, and traditional computational models, emphasizing their unique contribution to decision support, drug development, and therapeutic optimization. As digital healthcare ecosystems mature, ISTs represent a crucial step toward simulation-driven, individualized medicine. Their continued development offers substantial potential for improving outcomes, accelerating discovery, and reshaping the clinical landscape. Uniquely, this review introduces a practical taxonomy of IST architectures, a verification and validation checklist for model credibility, and a deployment blueprint to guide their clinical translation and real-world adoption.</p>","PeriodicalId":49257,"journal":{"name":"Saudi Pharmaceutical Journal","volume":"34 1","pages":"1"},"PeriodicalIF":4.3,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12738446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}