Dr Mir Javid Iqbal, a Kashmir scientist serving US pharma major Moderna in its Clinical Pharmacology and Pharmacometrics vertical tells Kashmir Life Science Talks that AI and Dep MachineLearning have pushed the pharmaceutical sciences in a new direction in which every patient gets the right medicine in the right dose at the right time as one-prescription for all is changing
KASHMIR LIFE (KL): From the days of using food as medicine to Unani and to allopathy and finally to antibiotics, the evolution of curing the sick has come a long way. What are the newer goalposts for pharmaceutical sciences?
DR JAVID IQBAL (JI): The advent of lifestyle changes and the emergence of new and advanced diseases pose a significant challenge for pharmaceutical experts. Addressing each novel disease requires an advanced treatment, necessitating dedicated efforts from scientists and researchers. Initially, the traditional system of medicine like Unani, Ayurveda, TCM provided relief for an extended period. However, with time, these treatment approaches became less effective with the expanding population and the increasing incidence of advanced diseases.
The fields of Computers, Information Technology, and Artificial Intelligence (AI) are ushering in a revolutionary transformation across all aspects of life. In the contemporary medical industry, the role of AI is becoming more relevant and significant. Certain drugs have been even manufactured using 3D and 4D printing technologies, employing various AI-based programs. These drugs receive approval from regulators like United States Food and Drug Administration (FDA) and are renowned for their reliability and effectiveness. Industry experts actively support the safety, quality, and efficacy of these drugs. I firmly believe that the amalgamation of existing knowledge, literature, and technology for the discovery and production of advanced AI-driven drugs is poised to be a substantial development and a forthcoming milestone for the pharmaceutical industry to strive towards a better future.
KL: Before discussing your scientific pursuits, enlighten us about your journey from Bandipora to Boston.
JI: The journey has been lengthy and challenging. I was born in Quil-Muqam village and received my primary education at the local government middle and high school. Subsequently, I pursued higher education in Bangalore. Following the completion of my Bachelor’s in Pharmacy, I joined a pharmaceutical company in the same city and served as a research executive for one and a half years.
My enduring fascination with science and the mechanisms of drug action prompted me to enrol at the University of Kashmir for my master’s degree, specialising in clinical pharmacy and pharmacy practice. This field focuses on bedside pharmacy rather than bench-side, representing a new and innovative direction in my academic pursuits. Later, I entered the PhD program under the guidance of my mentor, Prof Mohammad Ishaq Geer.
KL: What did you work on during your PhD programme and what were the main takeaways from your research?
JI: My PhD research closely aligned with the work I conducted during my Master’s degree. I realised that pursuing the same course for both master’s and PhD allows a researcher to extract the maximum benefit without being burdened by time constraints.
Under the guidance of Prof Ishaq, I embarked on a unique project known as Pharmaceutical Care, envisioning a pharmacist taking responsibility for the patient’s drug therapy. The pharmacist’s role involves monitoring and addressing drug-related needs and problems collaboratively with other healthcare providers and implementing necessary interventions. The ultimate goal of pharmaceutical care is to optimise drug therapy outcomes and mitigate adverse effects.
Initiating a distinctive clinical pharmacy service, or pharmaceutical care service, at a leading tertiary care hospital in Kashmir marked a significant milestone. The project gained recognition both domestically and internationally, with presentations in Australia and Mexico, leading to funding from these regions. Additionally, we secured travel grants from World Health Organization (WHO), CSIR and British Medical Journal.
Driven by my passion, I decided to focus on the rationalisation of drug therapy to maximise patient benefits. Coincidentally, during this time, Kashmir was engaged in a broader discussion about the Drug Policy and countering counterfeit medicines. Seizing the opportunity, we developed a Medicine Management Policy framework for tertiary care hospitals. This policy guides administrators, doctors, and other stakeholders in identifying, selecting, procuring, and managing drugs based on scientific principles and evidence-based standards.
Moreover, we drafted the first medicine management policy framework for Jammu and Kashmir, employing specific models for the forecasting and quantification processes. This framework serves as a comprehensive rule book for tertiary care hospitals, providing guidance on overall medicine management.
KL: Do you have a contribution to the present drug policy of Jammu and Kashmir?
JI:While I may not have made a direct contribution, there is an indirect impact. Working under Prof Ishaq’s guidance, we gathered on-the-ground evidence and identified the deficiencies in the existing drug policy. Our research also focused on evaluating drug policy recommendations and providing on-the-ground evidence. Consequently, my mentor’s contribution is more direct compared to others in this context.
KL: Did you opt for the postdoc after your PhD degree or did you decide to work in the pharma industry?
JI: Following the completion of my PhD, I relocated to Saudi Arabia and became a part of the pharmacy college at King Khalid University (KKU). Additionally, I used to have remote discussions with my cousin, Dr Tariq Rasool, focusing on the convergence of computer science and pharmacy. Our collaborative efforts involved the utilisation of Artificial Neural Networks and patient specific data that would aid doctors in predicting disease progression. This led to the development of some software applications also.
To further this initiative, I secured funding from King Khalid University through a grant I wrote, enabling me to delve into modelling endeavours using simulations and advanced statistical tools. The onset of the Covid19 pandemic proved to be a serendipitous opportunity for me. During this period, I briefly worked in a hospital, gaining access to Covid19 datasets for assessing treatment outcomes.
Concurrently, I published several papers. Subsequently, I relocated to the USA for a Postdoc fellowship, jointly funded by the biotechnology company Moderna and Northeastern University in Boston. Notably, I received a job offer from Moderna even before completing the postdoc. I joined as a scientist in Pharmacometrics and am currently employed there on a full-time basis..
KL:What is your job in Moderna about and what is the Pharmacometrics discipline all about?
JI: Pharmacometrics, a relatively recent discipline within pharmaceutical science, integrates various fields to acquire a comprehensive understanding of decision-making and facilitate efficient drug development. This involves quantifying information related to drugs, diseases, and trials. Data from pre-clinical and clinical studies, encompassing covariates, efficacy, and safety, is generated and analysed using statistical methods and principles of artificial intelligence, leading to diverse predictions.
The transition from pre-clinical to clinical studies in humans involves critical First in Human (FIH) trials. These trials, pivotal in drug development, aim to investigate the pharmacokinetics, dose concentration, and safety margins. Predictions are informed by existing literature and studies, providing a confidence interval for dose intake. Such simulations and predictions instil confidence in progressing to human trials. Subsequent population modelling, which involves testing a drug on a large and diverse population of both healthy and unhealthy individuals, offers insights into how a drug will perform in the general population, suggesting adjustments for clinical trials. This process provides the confidence needed to introduce a drug to clinical practice.
While working on the paediatric Covid19 vaccine, development we developed an immuno-stimulatory and immunodynamic model (ISID), which gave me a firm idea about the dosing patterns across different populations. At Moderna, I am currently working in the rare diseases space including the development of novel Monoclonal antibody treatment for Chikungunya, which is still in progress and is an investigational drug.
KL: We see cases of rising antibiotic resistance. Is this an indication of possible super-pandemics?
JI: The increasing resistance to antibiotics is a major cause for concern, leading to the utilisation of highly advanced antibiotics even today. However, it does not directly indicate a super pandemic. Instead, it highlights the potential for more challenging infectious diseases in the future. My master’s programme included a focus on understanding and addressing antibiotic resistance. To effectively confront this challenge, a comprehensive and collaborative approach is necessary. It is vital to engage all stakeholders, such as patients, healthcare providers, pharmacists, and policymakers. Rational drug therapy plays a crucial role in ensuring the proper use of antibiotics. Raising awareness among the general public about the risks of self-prescribing antibiotics and the importance of completing prescribed courses is imperative. Pharmacists, drawing on their expertise, can significantly contribute by offering appropriate counselling to patients. Moreover, implementing suitable methods for the disposal of unused medications and minimizing the environmental presence and impact of antibiotics are crucial considerations.
KL: What do you think about the gene editing technology? What is it up to? Where do you think it could go from here?
JI: Like any other technology, it will continue to advance over time. Currently, medications are not created for the general population but are tailored to individual profiles based on relevant variables. Similarly, gene editing technology is moving towards personalisation and widespread accessibility. However, ethical concerns arise in parallel. To ensure a balanced use of this technology, it is imperative to establish comprehensive regulations and safeguards to prevent its exploitation. Limits on the extent to which a specific gene can be edited must be defined. Instances of technology misuse pose a challenge to the scientific community, but with time, I am optimistic that we will have better answers and improved solutions.
(Mujtaba Hussain processed the interview.)