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Pharmacokinetic resistance is also relevant: overexpression of P-glycoprotein (P-gp), encoded by ABCB1 and also referred to as multidrug resistance protein 1 (MDR1), can lower intracellular PARPi exposure through increased drug efflux, contributing to treatment failure [146,323]

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If temporal arteritis is not the cause it will put your mind at rest and you will also have the opportunity to discuss your other vascular issues (the prominent veins in your hands and feet), which could be caused by a number of things (inflammatory condition, vasculitis, the aging process etc.)