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Introduction

Ontologies are a representation of domain knowledge using defined concepts and the relationships between those concepts in a manner understandable to both humans and machines.

With the IDMP Ontology, we can express statements about things such as substances or medicinal products. While some statements are universally true (e.g., "Amlodipine is a chemical substance" or "Amlodipine is included in Norvasc"), some statements are true only in specific situations/contexts, e.g., the strength of a certain substance makes sense only in the context of a product.

To capture the context, an established pattern in ontology modelling is to use "roles". E.g., a human Max can play the role "patient" in the context of a treatment. Or a substance can play the role "active ingredient" in the context of one pharmaceutical product while the same substance may play the role "excipient" in the context of a different product.

The role concept (hereafter referred to as 'role') and corresponding ontological role model pattern provide a structured and modular way to capture many different real-world complexities.

Related Competency Questions

  • What is the active moiety of <SUBSTANCE>?
  • What is the investigational/authorized medicinal product in <CLINICAL TRIAL>?

Relation to ISO-IDMP Standards

There is no general role pattern described in the ISO IDMP standards. However, roles are mentioned, e.g., for describing an ingredient in the context of a pharmaceutical product. See also Pattern: Ingredient - DRAFT

Modeling Pattern

In the following, we incrementally explain why we need roles, how contextualized roles are modeled in general and instantiated with examples.

Universal Statement (NO Role usage)

Example: Amlodipine Mesylate Monohydrate is included Amlodipine EMC (a pharmaceutical product)

Basic Role Pattern

In order to further specify a relationship, we use the basic role pattern that allows us to provide details about the role and about where the role is realized, appears, or occurs (through property "is manifested in")

The relationships "plays role" and "is played by" as well as the relationships "is manifested in" and "manifests" are inverse relationships respectively.

Of course, these general classes "Thing" and "Role" are instantiated with more specific subclasses, as illustrated in the next example:

Example: Amlodpine Mesylate Monohydrate plays role active ingredient in Amlodipine EMC

The important thing is that we can now attach all information that further specifies the role of Amlodipine mesylate monohydrate in Amlodipine EMC to the middle role node in the graph, e..g., the strength or further context specification (see below). 

If multiple roles need to be further grouped or a role doesn't uniquely connect an object with its manifestation, then the Pattern: Constituencies - DRAFT needs to be applied.


Role Hierarchy in IDMP-O

The role (https://www.omg.org/spec/Commons/PartiesAndSituations/Role) is modeled as a class and can be specialized with sub-classes, some of which are shown in diagram 2.

The role class and its specialized sub-classes.

Optional Context Definition

The context is a "situation" or frame of reference in which something applies, exists, happens, or is used, and that helps to illustrate or explain it. 

As for roles, "context can have subclasses to further specify its nature. 

Context and its sub-classes.


Examples

Modeling the active moiety role for Amlodipine bezylate in the regulatory context

Amlodipine bezylate is used here as a simple example to demonstrate the modeling pattern for contextualized roles, where Amlodipine plays the active moiety role for the drug Amlodipine bezylate in a regulatory context.


Diagram 4: Modeling Amlodipine as the active moiety for Amlodipine bezylate in a regulatory context

Modeling the different active moiety roles for Aripiprazole lauroxil in different contexts

Needs update see IDMP-514 : "Active Moiety for FDA Exclusivity" . TBD: Can we model this better as a role subclass?

The contextualized role pattern is used here to model interpretations of the active moiety role for Aripiprazole in different situations. Aristada is a drug developed by Alkermes and is composed of Aripiprazole lauroxil. Aripiprazole lauroxil is first metabolized to N-hydroxymethyl aripiprazole, which is then further metabolized to Aripiprazole which exerts pharmaceutical effects in the body. From a regulatory perspective, Aripiprazole is thus the active moiety. However, based on the interpretation of a patent by the US court, based on the fillings by the owner of the intellectual property (IP) on Aripiprazole lauroxil, the active component is stated as the N-hydroxymethylated product instead. Diagrams 5 and 6 below demonstrate how in different contexts, the active moiety for Aripiprazole lauroxil can be either N-hydroxymethyl aripripazole or Aripiprazole itself.

NOTE: The differences in interpretation of active moiety for Aripiprazole lauroxil came about, as Otsuka Pharmaceuticals challenged FDA's approval for a new drug application for Alkermes's drug Aristada (Aripiprazole lauroxil) stating that it ultimately metabolizes to Aripiprazole which is the active moiety for Otsuka Pharmaceutical's drug Abilify (Aripiprazole). However, under USP's salt policy, the active moiety for Aripiprazole lauroxil is designated as N-hydroxymethyl aripiprazole.

In the third example, the USP salt policy context is considered when naming the active moiety for Aripiprazole lauroxil. The USP (United States Pharmacopeia) Salt Policy outlines a naming and labeling approach for drug products containing an active ingredient that is a salt, and applies to drug product monograph titles published after the 1st of May 2013. According to the USP salt policy, Aripiprazole lauroxil is designated as the active moiety for Aripiprazole lauroxil (Diagram 7).



Moiety Role - N-hydroxymethyl aripiprazole - Patent Exclusivity

Diagram 5: Modeling N-hydroxymethyl aripiprazole as the active moiety for Aripiprazole lauroxil in a FDA patent exclusivity context


Moiety Role - Aripiprazole - Regulatory Context GSRS

Diagram 6: Modeling Aripiprazole as the active moiety for Aripiprazole lauroxil in a regulatory FDA GSRS context


Moiety Role - Aripiprazole - USP Salt Policy context

Diagram 7: Modeling Aripiprazole lauroxil as the active moiety for Aripiprazole lauroxil in a USP salt policy context



USP documentation


USP Salt Policy (December 2014) - YouTube



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