British journal of clinical pharmacology最新文献

{"title":"Paediatric rare diseases: Can large language models assist off-label prescribing?","authors":"Anna Flamigni, Giulia Zamagni, Gilda Paternuosto, Anna Arbo","doi":"10.1002/bcp.70168","DOIUrl":"https://doi.org/10.1002/bcp.70168","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the effectiveness and reliability of large language models (LLMs) in retrieving and synthesizing biomedical information to support off-label drug prescribing in paediatric rare diseases, and to compare their performance with human-authored references in terms of scientific rationale, adverse events and drug interactions.</p><p><strong>Methods: </strong>The study reviewed 20 cases of off-label prescriptions in rare paediatric diseases using 4 LLMs (i.e., GPT-4o, Sophos-2, Claude-3, Scopus AI). The queries addressed focused on scientific rationale, adverse events and drug interactions. The performance measures encompassed sensitivity, precision, accuracy, F1-score, response quality and reference quality. A Global Performance Score integrated all measures.</p><p><strong>Results: </strong>After evaluating 2758 references and 480 responses, a significant discrepancy was found among 4 LLMs concerning Global Performance Score (P = .001). Posthoc analysis showed that Scopus AI vs. GPT-4o comparison was significant, with GPT-4o showing higher values. Median LLM reference quality often surpassed human performance, yet variability limits conclusions regarding superiority.</p><p><strong>Conclusions: </strong>LLMs are capable of retrieving and synthesizing biomedical information, but performance varies depending on query type and search mode. These tools speed up retrieving relevant information to assess off-label prescribing appropriateness. Despite the promise of artificial intelligence, human oversight remains critical to ensure data accuracy and reliability.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic and pharmacodynamic modelling of continuous erythropoiesis receptor activator in children: A comprehensive analysis and real-world data validation.","authors":"Samer Mouksassi, Franz Schaefer, Bradley A Warady, Claus P Schmitt, Sylvie Meyer Reigner, Milena Studer, Pascal Chanu, Nicolas Frey","doi":"10.1002/bcp.70165","DOIUrl":"https://doi.org/10.1002/bcp.70165","url":null,"abstract":"<p><strong>Aims: </strong>To further assess the pharmacokinetic/pharmacodynamic characteristics of methoxy polyethylene glycol-epoetin β (continuous erythropoiesis receptor activator; C.E.R.A.) in children with chronic kidney disease (CKD) aged 3 months to 18 years undergoing different dialysis modalities and receiving intravenous/subcutaneous doses, compared with adults.</p><p><strong>Methods: </strong>The population pharmacokinetic and pharmacokinetic/pharmacodynamic C.E.R.A. models, developed using intravenous and subcutaneous data from adults with various dialysis modalities and intravenous data from children receiving haemodialysis, were updated with subcutaneous data from children receiving peritoneal dialysis or predialysis from the phase II paediatric study NH19708 (SKIPPER). Observed and predicted median C.E.R.A. doses and mean haemoglobin levels (indicative of response) were compared using paediatric clinical trials and real-world data from the MH40258 registry study.</p><p><strong>Results: </strong>The pharmacokinetic analysis in 627 patients, including 103 children aged 0.5-17 years, revealed that subcutaneous bioavailability in children was 2.18 times higher than in adults (67.1% [95% confidence interval: 52.6-81.6]). Distribution volume increased with weight and age, and clearance increased with weight. Incorporating dialysis modality as a covariate improved the pharmacokinetic/pharmacodynamic model's fit to haemoglobin data. The agreement of observed and predicted paediatric data with real-world data underscores the model's predictive performance and C.E.R.A.'s replicable clinical trial effects in clinical practice.</p><p><strong>Conclusions: </strong>This analysis enhanced our knowledge of C.E.R.A.'s effects in children with CKD, confirming its pharmacokinetic/pharmacodynamic characteristics align with adults. Comparison of clinical trial data, model prediction, and real-world data show that C.E.R.A. intravenous and subcutaneous dosing and procedures in adults and children provide adequate control of haemoglobin in clinical practice.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for use of Al/machine learning for pharmacovigilance: Is there a role for regulators?","authors":"Christina Gao, Ashley M Hopkins, Andrew Rowland, Stephen Bacchi","doi":"10.1002/bcp.70173","DOIUrl":"https://doi.org/10.1002/bcp.70173","url":null,"abstract":"","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing local and systemic exposure to clobetasol propionate in healthy subjects and patients with atopic dermatitis.","authors":"Janna K Duong, Sven van Dijkman, Gary Ong, Alexandra Marta, Adriana Ceci, Ernesto Bonifazi, Oscar Della Pasqua","doi":"10.1002/bcp.70102","DOIUrl":"https://doi.org/10.1002/bcp.70102","url":null,"abstract":"<p><strong>Aims: </strong>There is a potential risk of systemic side-effects with the use of potent corticosteroids, such as clobetasol propionate (CP). This concern is of particular interest in paediatric patients. The aim of this study was to develop and verify a physiologically based pharmacokinetic (PBPK) model to describe the local and systemic exposure to CP following topical application over a period of up to 4 weeks.</p><p><strong>Methods: </strong>Data from 12 clinical studies in healthy adult subjects and patients with atopic dermatitis (AD) were available for this investigation. A PBPK model including skin barrier impairment was developed to predict the effect of AD lesions on systemic exposure. Simulation scenarios were then evaluated to assess the effect of formulation, skin condition and surface area (5%-60% of body surface area [BSA]) on systemic exposure.</p><p><strong>Results: </strong>The PBPK model described the absorption and disposition characteristics of CP. Mean clearance, volume of distribution (V_ss) and renal clearance were 27 L/h, 2.34 L/kg and 0.12 L/h, respectively. The half-life of CP after topical application was significantly longer than after an IV dose (20.8 vs. 5.2 h). Systemic CP concentrations were higher with increasing surface area and skin barrier impairment. However, CP accumulates in the stratum corneum as the skin barrier function improves during treatment.</p><p><strong>Conclusions: </strong>Systemic and local exposure to CP increases with impaired skin barrier in AD and larger application area. Given the recommended maximum dose of 50 g per week, CP should not be applied to an area of more than 30% of the BSA. Availability of this model will allow extrapolation of CP pharmacokinetics from adults to children.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins as a risk factor for anaemia: Evidence from genetic and epidemiological data.","authors":"Zhekang Liu, Qingan Fu, Junda Cao","doi":"10.1002/bcp.70143","DOIUrl":"https://doi.org/10.1002/bcp.70143","url":null,"abstract":"<p><strong>Aims: </strong>Statins are widely used for managing dyslipidaemia and preventing cardiovascular events. Reports on whether statin use and anaemia are associated are scarce and controversial. The relationship between statins and anaemia remains unclear. This study aimed to explore the potential causal link between statin use and anaemia.</p><p><strong>Methods: </strong>We employed a two-sample Mendelian randomization (MR) approach using single nucleotide polymorphisms related to HMGCR expression, the gene targeted by statins, to evaluate the causal effect of statin use on anaemia. Genome-wide association study data specific to European populations were used to identify genetic associations, and clinical data from National Health and Nutrition Examination Survey (NHANES; 2005-2016) were analysed to validate the MR findings. Logistic regression models were used to assess the association between statin use and anaemia risk in the NHANES cohort.</p><p><strong>Results: </strong>MR analysis indicated that upregulation of HMGCR expression was associated with a reduced risk of anaemia (odds ratio = 0.72, 95% confidence interval 0.58-0.88; P = .007). In contrast, the analysis of NHANES data revealed that statin use was significantly associated with an increased risk of anaemia (odds ratio = 1.624, 95% confidence interval 1.307, 2.018; P < .001). Sensitivity analyses revealed the reliability of the MR results, and the association between statin use and anaemia was further supported by the consistency of univariate and multivariate regressions in NHANES.</p><p><strong>Conclusions: </strong>Our findings suggest that while genetic up-regulation of HMGCR may reduce anaemia risk, statin therapy is associated with an increased risk of anaemia. These results highlight the need for careful monitoring of haemoglobin and iron levels in patients undergoing long-term statin treatment, especially those with pre-existing risk factors for anaemia. Further research is necessary to elucidate the underlying mechanisms and to confirm these findings in diverse populations.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrapolation of lung pharmacokinetics of bedaquiline across species using physiologically-based pharmacokinetic modelling.","authors":"Evangelos Karakitsios, Oscar Della Pasqua, Aristides Dokoumetzidis","doi":"10.1002/bcp.70163","DOIUrl":"https://doi.org/10.1002/bcp.70163","url":null,"abstract":"<p><strong>Aims: </strong>BeBedaquiline (BDQ) is a first-in-class diarylquinoline (DARQ) and a potent anti-tuberculosis drug, vital in combating multi-drug resistant tuberculosis (TB). Understanding its lung pharmacokinetics (PK) across species is crucial for effective clinical translation. This study aimed to extrapolate BDQ's lung PK from preclinical species to humans, focusing on healthy and TB-infected lung tissue.</p><p><strong>Methods: </strong>Physiologically-based PK (PBPK) modelling was employed to simulate BDQ's lung distribution in various pulmonary micro-compartments, including cellular lesions and caseous granulomas, using data from mice, rats and dogs. Complex interactions, such as lysosomal trapping within macrophages and anomalous diffusion within the caseum, utilising a catenary model and a time-dependent rate, were incorporated into the models to accurately represent BDQ's unique PK profile.</p><p><strong>Results: </strong>The study revealed intricate dynamics of BDQ's lung distribution, with only free concentrations in lysosomes of macrophages surpassing the MIC of Mycobacterium tuberculosis in both mice and humans, indicating intracellular accumulation which may further explain the proven drug's efficacy. Moreover, during the course of treatment in humans, adequate drug levels were achieved near the cellular rim but penetration into the inner caseous core was predicted to be limited.</p><p><strong>Conclusions: </strong>Understanding BDQ's lung PK is essential for optimising dosing strategies with new companion drugs. The findings underscore the need to characterise BDQ distribution within the caseum, as it shows extensive caseum binding. Moreover, the developed PBPK model can be applied to new promising DARQ analogues, facilitating their development as effective TB treatments.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the utilization, expenditure and costs of noninsulin glucose-lowering drugs in the Medicaid population: Steady increases in glucagon-like peptide-1 receptor agonist and sodium-glucose transporter-2 inhibitor use, prices and expenditure.","authors":"Rawan O Almadfaa","doi":"10.1002/bcp.70162","DOIUrl":"https://doi.org/10.1002/bcp.70162","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to analyse changes in the utilization, expenditure and average cost of noninsulin glucose-lowering drugs (GLDs) between 2008 and 2023.</p><p><strong>Methods: </strong>This was a retrospective observational study of 2008-2023 data from the National Medicaid State Drug Utilization database. Drug utilization and annual Medicaid reimbursement amounts were calculated for all included medications. Average reimbursement/prescription costs were used to represent average prices. The Mann-Kendall test and Sen's slope estimator were used to evaluate trend significance and estimate median annual changes with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Findings showed a significant increase in the total annual utilization (z = 4.997, Sen's slope: 2.53 million [95% CI: 2.26-2.95 million]), reimbursement amounts (z = 4.997, Sen's slope: $679 million [95% CI: $389 million-$1.04 billion]) and average prices (z = 3.467, Sen's slope: $13.24 [95% CI: $5.97-$21.53]) of the included drugs between 2008 and 2023 (all P < .001; Mann-Kendall test). Metformin dominated the market, accounting for 53% of the prescriptions, followed by sulfonylureas (20.5%). Medicaid spent $2.8 billion on metformin and $1.2 billion on sulfonylureas. This is relatively low compared to expenditure on other medications, such as glucagon-like peptide-1 (GLP-1) receptor agonists, which reached $35.5 billion. There was a notable shift toward the use of GLP-1 receptor agonists and sodium-glucose transporter-2 inhibitors, accompanied by a significant increase in their average cost and Medicaid spending on these drugs.</p><p><strong>Conclusions: </strong>Metformin and sulfonylureas have remained the most prescribed and affordable noninsulin GLDs. However, there has been a shift toward greater utilization of GLP-1 receptor agonists and sodium-glucose transporter-2 inhibitors.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interindividual variability in olanzapine steady-state concentrations in Chinese: exploring single nucleotide polymorphisms of metabolic enzymes.","authors":"Zhou Wan, Yan-Nan Zang, Fei Jia, Qi Yang, Wen-Wei Chen, Chen-Geng Liu, Xin-Gang Li, Jose de Leon, Can-Jun Ruan","doi":"10.1002/bcp.70161","DOIUrl":"https://doi.org/10.1002/bcp.70161","url":null,"abstract":"<p><strong>Aims: </strong>Olanzapine steady-state concentration can vary due to several factors. This study explores how physiological factors, smoking status, inflammation status, concomitant medications and metabolic enzyme single nucleotide polymorphisms (SNPs) influence its metabolic levels, aiming to guide personalized dosing.</p><p><strong>Methods: </strong>This study analysed data from 310 olanzapine-treated patients at Beijing Anding Hospital. Liquid chromatography-mass spectrometry quantified 1002 serum concentrations. Eleven SNPs from CYP1A2, CYP3A5, UGT1A4 and FMO1/3 were identified through real-time fluorescence quantitative polymerase chain reaction. A Bayesian network was applied to elucidate causal relationships between variables, followed by g-computation to quantify the effect of individual factors on the dose-adjusted concentration (C/D ratio) of olanzapine. The Wilcoxon signed-rank test assessed the intraindividual variations in the steady-state C/D ratio.</p><p><strong>Results: </strong>The Bayesian network suggested causality between smoking, sex, sertraline, Danggui-Longhui, valproic acid and the olanzapine C/D ratio. None of the SNPs reached significance levels. The Wilcoxon signed-rank test confirmed that both polypharmacy and inflammation increased the C/D ratio within individuals. G-computation showed that the olanzapine C/D ratio decreased by 1.135 in males and 0.821 with smoking. Danggui-Longhui, sertraline and valproic acid reduced the ratio by 1.134, 0.92427 and 0.832, respectively.</p><p><strong>Conclusion: </strong>Our study confirms that sex, age, smoking, inflammation and coprescription with sertraline, Danggui-Longhui and valproic acid contributed to variability in olanzapine's steady-state concentration. Considering these factors in clinical practice may help to personalize olanzapine treatment in Asian patients.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential for clinical pharmacists to support older people with dementia in the community: A qualitative interview study.","authors":"Alice Burnand, Abi Woodward, Kumud Kantilal, Cini Bhanu, Yogini Jani, Jill Manthorpe, Mine Orlu, Greta Rait, Madiha Sajid, Kritika Samsi, Victoria Vickerstaff, Jane Ward, Jane Wilcock, Nathan Davies","doi":"10.1002/bcp.70160","DOIUrl":"https://doi.org/10.1002/bcp.70160","url":null,"abstract":"<p><strong>Aims: </strong>The prevalence of multiple long-term health conditions including dementia is rising globally. Managing dementia presents significant challenges for healthcare providers. Clinical pharmacists, with expertise in medication management, have emerged as valuable members of the primary care team. However, there is a need for further research to understand their specific role and experiences in supporting people with dementia. The aim of this paper was to explore the views and experiences of primary care based clinical pharmacists in supporting people with dementia in the community.</p><p><strong>Methods: </strong>We conducted 13 semistructured interviews with primary care clinical pharmacists in England in 2023-2024. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three overarching themes were developed from the data: (i) holistic care beyond medication management; (ii) the integral role and capacity of clinical pharmacists in the healthcare team and system when delivering dementia care; and (iii) building expertise in dementia care and defining the role of a clinical pharmacist.</p><p><strong>Conclusion: </strong>Clinical pharmacist roles have the potential to extend beyond medication management to deliver holistic support, as part of primary care based multidisciplinary teams and take a proactive approach to care for people with dementia. Findings highlight the importance of confidence, training and a supportive workplace environment for clinical pharmacists to effectively contribute to dementia care.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence modelling of tyrosine kinase inhibitors at risk of malabsorption and bioavailability-enhancing strategies.","authors":"Daan W Huntjens, Olivier J M Béquignon, Stefanie D Krens, Mark Löwenberg, Martine E D Chamuleau, Remco J Molenaar, Anita M G Kramers, Marianne A Kuijvenhoven, Imke H Bartelink","doi":"10.1002/bcp.70166","DOIUrl":"https://doi.org/10.1002/bcp.70166","url":null,"abstract":"<p><strong>Aims: </strong>The study aims to predict and improve the absorption of tyrosine kinase inhibitors (TKIs) in patients with malabsorption issues, particularly those who have undergone bariatric surgery or are using proton-pump inhibitors. The research involves 2 main components: the development of an artificial intelligence (AI) model to identify TKIs that are susceptible to reduced absorption in these patients, and the application of case-specific absorption enhancements based on 2 clinical scenarios.</p><p><strong>Methods: </strong>A fully connected neural network was applied using pH-dependent solubility data from 137 785 compounds to identify TKIs at risk of reduced bioavailability when bypassing the stomach. The clinical impact of gastric acid suppressants on the bioavailability of 71 approved TKIs was evaluated by correlating the AI solubility estimates with the effect of proton-pump inhibitors on clinical exposure. Furthermore, absorption enhancement was applied in 2 clinical scenarios, with therapeutic drug monitoring assessing the effectiveness of the enhancement.</p><p><strong>Results: </strong>Two AI models were developed to predict the difference in molecular aqueous solubility between acid and neutral pH and to capture the concentration available for intestinal absorption in healthy and in patients with malabsorption issues. The AI model capturing the solubility difference between acidic and neutral pH demonstrated predictive capabilities, with a Pearson correlation coefficient of .95 and a coefficient of determination of .90. It predicted that the solubility difference, between acidic and neutral pH, was associated with clinical bioavailability (P < .001). Nilotinib, lapatinib and dacomitinib were ranked as TKIs with the highest risk of malabsorption in case of increased stomach pH.</p><p><strong>Conclusion: </strong>We developed an AI-based model that predicts TKIs that are at risk of malabsorption when bypassing the stomach or used with gastric acid suppressants. Drugs with a high malabsorption risk can be enhanced by various methods to improve bioavailability.</p>","PeriodicalId":9251,"journal":{"name":"British journal of clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}