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Knop: Despite the relatively small number of patients included in our study, it nevertheless represents one of the largest randomized, controlled trials investigating the effect of medical therapies for bile acid diarrhea

Overall, these data support the human observations and show increased zonulin levels, reduced TJ protein complex expression and impaired intestinal barrier function preceding the onset of arthritis

However, since a larger fraction of the total drug in the body is now free, the steady-state concentration of free drug increases significantly, posing a major risk of toxicity