Discussion
liver injury, inflammation, abnormal liver function, Liver dysfunction
REGRESSION, INFLAMMATION, DRUG INTERACTIONS, PCT
In many studies, most CYP2C19 mutations involved three common alleles in the Chinese Han population, namely CYP2C19 *2,*3, and *17 (Due to the high bioavailability of oral dosage form (96%) according to VCZ’s label, the intravenous and oral routes of administration are interchangeable when clinically indicated. In the study, 306 patients were treated with different routes of administration for VCZ (Intravenous, oral and sequential therapy). The results showed no noticeable difference in different routes of administration between groups A and B (Although CRP and IL-6 are known to be involved in the high fluctuation of VCZ-These findings indicate that high inflammation, reflected by CRP, PCT, and IL-6, can affect the pharmacokinetics of VCZ, resulting in an increase in Our study found that a multiple linear stepwise regression did not identify PPIs or glucocorticoids as significant covariates for VCZ exposure. These covariates may be due to multiple factors, such as high inflammation and poor metabolism genotype, that could mask the results of drug interactions. Previous studies have shown that VCZ exposure increases with the type of PPI used (Although CPICIn addition to the significant covariates that affect the VCZ maintenance dose mentioned above, several other covariates must be considered. Liver dysfunction affects the clearance of VCZ, and patients with abnormal liver function often experience increased VCZ exposure due to slowed clearance when using conventional doses. The established model is based on patients with normal liver function without considering the effect of liver injury on the dose. Therefore, for patients with abnormal liver function, the dose should be appropriately reduced based on the recommended dose of the model during clinical treatment with VCZ. For individual patients whose VCZ maintenance dose is less than 200 mg/d or more than 600 mg/d, a significant deviation from the predicted dose appears in the established prediction model. There may be some other influencing factors that still need to be discovered.