Association of valproic acid and its main metabolites' plasma concentrations with clinical outcomes among epilepsy patients: a 10-year retrospective study based on therapeutic drug monitoring.

It was the first and largest observational cohort in China to explore the relationship between patients' parent and metabolites concentrations of VPA and clinical outcomes in epileptic patients with VPA monotherapy. Our study provided feasible references of VPA for epilepsy clinical treatment with a considerable sample size compared with previous studies for a more definitive conclusion. We found two potential biomarkers in predicting efficacy and liver injury respectively. This breakthrough has the potential to assist in rational use of VPA.