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However, it remains unclear how genetic factors related to the disposition and clinical response of LCM, as well as drug\u2013drug interactions (DDIs), exert their influence on pediatric patients with epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the impact of genetic variations and DDIs on plasma LCM concentrations and clinical response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Patients with epilepsy treated with LCM from June 2021 to March 2023 in the Children\u2019s Hospital of Nanjing Medical University were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The demographic information and laboratory examination data were obtained from the hospital information system. For the pharmacogenetic study, the left-over blood specimens, collected for routine plasma LCM concentration monitoring, were used to perform genotyping analysis for the selected 26 single nucleotide polymorphisms from 14 genes. The trough concentration\/daily dose (\n                      <jats:italic toggle=\"yes\">C<\/jats:italic>\n                      <jats:sub>0<\/jats:sub>\n                      \/D) ratio and efficacy outcomes were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients achieved 90.1% and 68.9% responder rates in LCM mono- and add-on therapy, respectively. The genetic variant in the\n                      <jats:italic toggle=\"yes\">CYP2C19<\/jats:italic>\n                      *2 (rs4244285) was associated with a better responsive treatment outcome (odds ratio: 1.82; 95% confidence interval: 1.05\u20133.15;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.031). In monotherapy, 36% of patients were CYP2C19 normal metabolizers (NMs), 49% were intermediate metabolizers (IMs), and 15% were poor metabolizers (PMs) carrying\n                      <jats:italic toggle=\"yes\">CYP2C19<\/jats:italic>\n                      *2 or *3. Of note, the\n                      <jats:italic toggle=\"yes\">C<\/jats:italic>\n                      <jats:sub>0<\/jats:sub>\n                      \/D ratios of IMs and PMs were 9.1% and 39.6% higher than those of NMs, respectively. Similar results were in the add-on therapy group, and we also observed a substantial decrease in the\n                      <jats:italic toggle=\"yes\">C<\/jats:italic>\n                      <jats:sub>0<\/jats:sub>\n                      \/D ratio when patients were concomitant with sodium channel blockers (SCBs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      This study was the first to confirm that\n                      <jats:italic toggle=\"yes\">CYP2C19<\/jats:italic>\n                      *2 or *3 variants impact the disposition and treatment response of LCM in children with epilepsy. Moreover, concomitant with SCBs, particularly oxcarbazepine, also decreased plasma LCM concentration.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864241273087","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T07:17:07Z","timestamp":1767683827000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["<i>CYP2C19<\/i>\n                    genotype and sodium channel blockers in lacosamide-treated children with epilepsy: two major determinants of trough lacosamide concentration or clinical response"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-150X","authenticated-orcid":false,"given":"Yue","family":"Li","sequence":"first","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Li","family":"Guo","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wang","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"},{"name":"School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Fan","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical University, Nanjing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Hui","family":"Hu","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences Research Center, Department of Pharmacy, Children\u2019s Hospital of Nanjing Medical 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