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Article History

Received: 13 April 2026

Accepted: 8 September 2026

First Online: 19 September 2026

Declarations

Conflicts of Interest: Gianluca Trifirò has served, over the last 3 years, on advisory boards/seminars funded by Sanofi, MSD, Eli Lilly, Sobi, Celgene, Daiichi Sankyo, Novo Nordisk, Gilead, and Amgen on topics not related to content of this paper; he is also a scientific coordinator of the academic spin-off “INSPIRE srl,” which has received funding from several pharmaceutical companies (Kiowa Kirin, Shionogi, Shire, Novo Nordisk, and Daiichi Sankyo) for conducting observational studies and additional consultancy services on topics not related to content of this paper. Additionally, he is currently a consultant for Viatris in a legal case concerning an adverse reaction to sertraline. None of these listed activities are related to the topic of the article. Gianluca Trifirò is an Editorial Board member of Drug Safety . Gianluca Trifirò was not involved in the selection of peer reviewers for the manuscript nor in any of the subsequent editorial decisions. The other authors have no conflict of interest to declare.

Ethics Approval: Not applicable. This study did not use personal data.

Consent to Participate: Not applicable.

Consent for Publication: Not applicable.

Authors’ Contribution: Massimo Carollo: writing—original draft, writing—review and editing, data curation. Anna Forti: writing—review and editing, data curation. Salvatore Crisafulli: writing—original draft, writing—review and editing. Luca L’Abbate: data curation and analysis. Irene Cristini: writing—original draft, writing—review and editing. Federica Soardo: writing—review and editing, data curation. Marilisa Giustina Stano: writing—review and editing, data curation. David Bellantuono: writing—review and editing. Davide Benetti: writing—review and editing, data curation. Riccardo Lora: writing—review and editing, data curation, conceptualization. Gianluca Trifirò: writing—review and editing, validation, supervision, conceptualization. All authors read and approved the final version.

Availability of Data and Material: The reference list and algorithm outputs supporting the findings of this study are provided in the ESM, Online Resource Tables  and . The Italian Summaries of Product Characteristics used as source documents are publicly available from the Italian Medicines Agency. Additional data are available from the corresponding author upon reasonable request.

Code Availability: The source code is not publicly available because it is integrated into the Prescribing INappropriateness Assessment (PINA) software, which is currently under development. The algorithmic logic and the four semantic-matching configurations evaluated in this study are described in the Sect. 2. Further information is available from the corresponding author upon reasonable request.

AI Use: No AI tools were used.