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  <front>
    <journal-meta>
      <journal-id journal-id-type="iso-abbrev">Pharmacophore</journal-id>
      <journal-id journal-id-type="publisher-id">pharmacophorejournal.com</journal-id>
      <journal-id journal-id-type="publisher-id">Pharmacophore</journal-id>
      <journal-title-group>
        <journal-title>Pharmacophore</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2229-5402</issn>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">pharmacophorejournal.com-6975</article-id>
      <article-id pub-id-type="doi">10.51847/49pN9Gi36y</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original research</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Drug Repurposing as Evidence Reconciliation across Disease Signatures, Molecular Mechanisms, Prior Failures, and Clinical Context</article-title>
      </title-group>
                    <contrib-group>
                      <contrib contrib-type="author">
              <name>
                <surname>Costa</surname>
                <given-names>Rui</given-names>
              </name>
                              <xref rid="aff1" ref-type="aff">1</xref>
                                                            <xref rid="cor1" ref-type="corresp" />
                          </contrib>
                      <contrib contrib-type="author">
              <name>
                <surname>Watson</surname>
                <given-names>Emily</given-names>
              </name>
                              <xref rid="aff2" ref-type="aff">2</xref>
                                        </contrib>
                      <contrib contrib-type="author">
              <name>
                <surname>Benziane</surname>
                <given-names>Karim</given-names>
              </name>
                              <xref rid="aff3" ref-type="aff">3</xref>
                                        </contrib>
                      <contrib contrib-type="author">
              <name>
                <surname>Silva</surname>
                <given-names>Andre</given-names>
              </name>
                              <xref rid="aff4" ref-type="aff">4</xref>
                                        </contrib>
                  </contrib-group>
                  <aff id="aff1">
            <label>1</label>Department of Drug Repurposing and Evidence Reconciliation, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
          </aff>
                  <aff id="aff2">
            <label>2</label>Department of Disease Signatures and Molecular Mechanisms, Faculty of Pharmacy, University of Glasgow, Glasgow, United Kingdom.
          </aff>
                  <aff id="aff3">
            <label>3</label>Department of Prior Failure Analysis and Clinical Context, Faculty of Sciences, University of Algiers, Algiers, Algeria.
          </aff>
                  <aff id="aff4">
            <label>4</label>Department of Repurposing Decision Support, Faculty of Pharmacy, University of Porto, Porto, Portugal.
          </aff>
                          <author-notes>
            <corresp id="cor1">
              <bold>Address for correspondence:</bold> Prof. Wael Abu Dayyih, Department of
              Pharmaceutical Chemistry, Faculty of Pharmacy, Mutah University, Al-Karak 61710, Jordan.
                              E-mail: <email xlink:href="rui.costa@uc.pt">rui.costa@uc.pt</email>
                          </corresp>
          </author-notes>
                    <pub-date pub-type="epub">
        <day>28</day>
        <month>02</month>
        <year>2025</year>
      </pub-date>
      <volume>16</volume>
      <issue>1</issue>
      <fpage>103</fpage>
      <lpage>111</lpage>
      <permissions>
        <copyright-statement>
          Copyright: &#x000a9; 2026 Pharmacophore
        </copyright-statement>
        <copyright-year>2026</copyright-year>
        <license>
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/"
            specific-use="textmining" content-type="ccbyncsalicense">
            https://creativecommons.org/licenses/by-nc-sa/4.0/</ali:license_ref>
          <license-p>This is an open access journal, and articles are distributed under the terms of
            the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
            others to remix, tweak, and build upon the work non-commercially, as long as appropriate
            credit is given and the new creations are licensed under the identical terms.</license-p>
        </license>
      </permissions>
      <abstract>
        <title>A<sc>BSTRACT</sc></title>
        <p>Drug repurposing promises to shorten parts of therapeutic development by redirecting existing compounds toward new disease indications, yet computationally attractive candidates often receive inconsistent support across transcriptomic signatures, molecular networks, genetics, phenotypic assays, observational data, and prior clinical studies. The unresolved problem is not simply insufficient prediction accuracy. It is the absence of a disciplined method for interpreting evidence sources that differ in biological scale, causal proximity, directionality, context, uncertainty, and translational authority. This article develops a proposed therapeutic evidence-synthesis model in which repurposing is treated as evidence reconciliation rather than score aggregation. The model distinguishes disease-state representation, target-mechanism plausibility, phenotypic response, human causal evidence, prior clinical outcomes, and context transfer as separate evidentiary layers. It further proposes that candidate prioritization should depend on compatibility among these layers, explicit accounting for contradictory and negative findings, and staged decision gates that prevent molecular plausibility from being mistaken for therapeutic readiness. The synthesis emphasizes that supportive evidence can converge without being equivalent, while apparent disagreement may reflect differences in cell type, dose, timing, population, endpoint, disease stage, modality, or mechanism. The proposed contribution is conceptual and requires retrospective and prospective evaluation. It cannot establish efficacy, safety, regulatory acceptability, or deployment readiness for any candidate. Its principal implication is that repurposing systems should expose why evidence agrees or conflicts, how close each signal lies to the intended therapeutic mechanism, and which uncertainties must be resolved before a hypothesis advances toward experimental or clinical testing.</p>
      </abstract>
      <kwd-group>
                <kwd>Drug repurposing</kwd>
                <kwd>Evidence reconciliation</kwd>
                <kwd>Disease signatures</kwd>
                <kwd>Molecular mechanisms</kwd>
                <kwd>Negative evidence</kwd>
                <kwd>Causal proximity</kwd>
              </kwd-group>
    </article-meta>
  </front>
</article>