{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:00:10Z","timestamp":1777950010761,"version":"3.51.4"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Valproic acid (VPA) is widely used in pediatric epilepsy, but its blood concentrations vary considerably among pediatric patients with epilepsy. This study aimed to investigate the factors influencing VPA blood concentrations in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included patients with epilepsy aged 0\u201318 years who were treated with VPA. Clinical data collected included age, gender, daily dose, biochemical parameters (liver and renal function), and electrolyte levels. VPA blood concentrations were measured by immunoassay. Correlation analyses and linear regressions were conducted to assess associations between clinical variables and VPA blood concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean VPA blood concentration was 69.82 \u00b1 25.22\u00a0\u03bcg\/mL, and 70.06% of patients had blood concentrations within the therapeutic range. Daily dose was positively correlated with blood concentration (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.319,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Age was significantly associated with VPA blood concentration, with younger children (&amp;lt;6 years) receiving lower daily doses and exhibiting lower blood concentrations than older age groups (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Creatinine and globulin levels were positively correlated with VPA blood concentrations (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), whereas alanine aminotransferase levels showed a negative correlation with blood concentrations (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Notably, calcium and phosphorus levels were negatively correlated with VPA blood concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VPA blood concentrations in the study population were influenced by multiple factors, including daily dose, age, renal and hepatic function, and electrolyte status. Given the marked inter-individual variability, individualized treatment guided by therapeutic drug monitoring (TDM) is essential for optimizing dosing accuracy and therapeutic efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1793966","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:32:51Z","timestamp":1777872771000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimization of individualized therapy with oral valproic acid in pediatric patients with epilepsy based on factors influencing blood concentrations"],"prefix":"10.3389","volume":"17","author":[{"given":"Yinhui","family":"Qin","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shandong Academy of Chinese Medicine","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panpan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Medicine, Henan Engineering Research Center of Funiu Mountain\u2019s Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University","place":["Pingdingshan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuetai","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Jinan Vocational College of Nursing","place":["Jinan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengchao","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenkun","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihong","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Henan Provincial People\u2019s Hospital, Zhengzhou University People\u2019s Hospital, Henan University People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1007\/s00467-022-05869-8","article-title":"Kidney tubular injury induced by valproic acid: systematic literature review","volume":"38","author":"Anguissola","year":"2023","journal-title":"Pediatr. 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