The Influence of CYP2C19 Polymorphism on Eradication of Helicobacter pylori: A Prospective Randomized Study of Lansoprazole and Rabeprazole

被引:29
作者
Lee, Jeong Hoon [1 ]
Jung, Hwoon-Yong [1 ]
Choi, Kee Don [1 ]
Song, Ho June [1 ]
Lee, Gin Hyug [1 ]
Kim, Jin-Ho [1 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Gastroenterol, Seoul 138736, South Korea
关键词
Helicobacter pylori; CYP2C19; Proton pump inhibitor; Lansoprazole; Rabeprazole; PROTON PUMP INHIBITOR; MEPHENYTOIN HYDROXYLATION DEFICIENCY; PEPTIC-ULCER DISEASE; TRIPLE THERAPY; S-MEPHENYTOIN; EXTENSIVE METABOLIZERS; GENETIC-POLYMORPHISM; INTRAGASTRIC PH; CURE RATES; INFECTION;
D O I
10.5009/gnl.2010.4.2.201
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: The CYP2C19 polymorphism plays an important role in the metabolism of various proton-pump inhibitors. Several trials have produced conflicting data on eradication rates of Helicobacter pylori (H. pylon) among CYP2C19 genotypes. We investigated whether the CYP2C19 genotype affects the eradication rate of H. pylori by direct comparing the effects of lansoprazole- and rabeprazole-based triple therapies. Methods: A total of 492 patients infected with H. pylori was randomly treated with either 30 mg of lansoprazole or 20 mg of rabeprazole plus 500 mg of clarithromycin and 1,000 mg of amoxicillin twice daily for 1 week. CYP2C19 genotype status was determined by a PCR-restriction-fragment-length polymorphism method. After 7 to 8 weeks, H. pylon status was evaluated by a C(13)-urea breath test. Results: Four hundred and sixty-three patients were analyzed, and the eradication rate was 75.2% in a per-protocol analysis. Eradication rates for the lansoprazole regimen (n=234) were 73.8%, 80.7%, and 85.4% in the homozygous extensive (HomEM), heterozygous extensive (HetEM), and poor metabolizers (PM) groups, respectively (p=0.303). In the case of the rabeprazole regimen (n=229), the eradication rates were 68.6%, 73.0%, and 71.9% in the HomEM, HetEM, and PM groups, respectively (p=0.795). Conclusions: The efficacies of triple therapies that include lansoprazole or rabeprazole are not affected by CYP2C19 genetic polymorphisms. (Gut Liver 2010;4:201-206)
引用
收藏
页码:201 / 206
页数:6
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