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Hepatic clearance accounts for roughly 25% of total apixaban elimination, primarily through CYP3A4 with minor contributions from CYP1A2, CYP2C8, CYP2C9, CYP2C19, and CYP2J2 [2]

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This response may include cytotoxic antibodies, stimulatory antibodies, blocking antibodies, or cell mediated immunity

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Some infections can also affect the pituitary gland