DDIAgents: Mechanism-Conditioned Context Flow for Drug-Drug Interaction Prediction

Mechanism-level drug-drug interaction (DDI) prediction requires identifying which enzyme or pharmacodynamic axis is implicated, in which direction, and with which evidence -- not merely whether two drugs interact. We introduce a reproducible mechanism-level DDI labelling and evaluation protocol with a structured 7-family/147-subtype taxonomy, leakage-safe cold-split protocols, and auditable reasoning metrics for evaluating pharmacological prediction beyond flat interaction classification. We propose a pipeline that produces a 7B reasoning MARD (Mirror-Augmented Reasoning Distillation), combining three training innovations: a single-token KL divergence on direction tag that ties the model's prediction, per-loss PRM-weighted DPO with programmatic hard negatives, and a leakage-safe mechanism-aware retrieval channel. Process-reward step labels are automatically verifiable against DrugBank-structured fields, requiring no human or LLM judges. On the April-2026 DrugBank release, our MARD-7B is the only system in a 32-system comparison whose accuracy survives drug-pair novelty, beating the best baseline by +13.9 pp and GPT-4o by +6.7 pp at ~1% of frontier API cost. Further analysis reveals an anti-memorisation signature where accuracy improves on rarely seen drugs, suggesting that gain comes from structured pharmacological reasoning rather than drug-frequency memorisation. We release corpus, DDI-PRM, retrieval index, and training code.

Cold-start drug-drug interaction (DDI) prediction for new drugs is critical for minimizing unexpected adverse drug reactions. The key challenge is to capture similarity between new and known drugs. However, such similarity is closely associated with complex relationships and mechanisms among drugs, enzymes, transporters, molecular structures, and other biomedical entities. Existing methods have three limitations in capturing such similarity: (1) only partial relationships and mechanisms are considered, which overlooks cross-modal information and yields incomplete or biased similarity modeling; (2) similarity computation between new and known drugs is conducted separately across modalities and performed offline for cold-start DDI prediction, leading to misalignment between similarity computation and DDI prediction; and (3) existing interpretability analyses are typically single-modality and focus primarily on key determinants of the perpetrator drug, while the underlying causes of susceptibility for the victim drug are seldom investigated. To address these issues, this paper proposes a novel Cross-Modal-Fused End-to-End Learning Network (CMF-ELN) with three components. First, diverse multimodal information is leveraged to construct four types of drug-centered knowledge graphs, enabling comprehensive similarity modeling under reconstruction-based supervision. Second, a four-channel graph autoencoder is designed to fuse cross-modal similarity within an end-to-end learning framework. Finally, a two-stage interpretability scheme is devised to precisely localize key factors for both perpetrator and victim drugs. Extensive experiments on two real datasets demonstrate that CMF-ELN achieves significantly higher prediction accuracy and more comprehensive interpretability of mechanisms than its peers.

Workflows in drug-target interaction (DTI) assessment require integrating heterogeneous data from predictive models, curated resources, and observations from experimental literature. This evidence can be incomplete or conflicting. DrugAgent is a large language model (LLM)-based multi-agent system focused on DTI evidence integration that integrates outputs from machine learning, knowledge graph, and retrieval-augmented generation (RAG) agents. DrugAgent converts agent outputs into interpretable representations, then summarizes conflict across the evidence. We evaluated DrugAgent on kinase screening data of 900 pairs spanning 178 kinases and 42 inhibitors, and an androgen receptor antagonist screening benchmark. On the kinase dataset, LLM-as-a-Judge evaluation indicated outputs were faithful to input evidence in 98.8% of cases. Biological plausibility of returned summarization was high (scores 3-4 out of 5) across ground-truth classes: 79% of Weak activity labels cases (81% for Moderate/77% Strong); Strong cases received higher scores than Weak/Moderate. Label stability showed 98% agreement across runs. Results on the antagonist benchmark were consistent with the kinase dataset. Retrieved literature provided the greatest benefit when direct drug-target evidence was available, highlighting the importance of evidence availability for RAG-based integration. DrugAgent provides heterogeneous evidence-grounded DTI assessment, complementing standalone DTI prediction. We provide strategies to model agreement, conflict, and uncertainty in biomedical evidence integration. Code: https://github.com/sciluna/DrugAgent.