The Influence of CYP2C19 Polymorphism on Eradication of Helicobacter pylori: A Prospective Randomized Study of Lansoprazole and Rabeprazole
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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. pylori) 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. pylori status was evaluated by a C13-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.
Abstract
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. pylori) 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. pylori status was evaluated by a C13-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.
참고문헌 (33)
- NIH Consensus Conference, "Helicobacter pylori in peptic ulcer disease. NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease", JAMA, 272, pp.65~69 (1994)
- Lam SK, "Report of the 1997 Asia Pacific Consensus Conference on the management of Helicobacter pylori infection", J Gastroenterol Hepatol, 13, pp.1~12 (1998)
- Chey WD, "American College of Gastroenterology guideline on the management of Helicobacter pylori infection", Am J Gastroenterol, 102, pp.1808~1825 (2007)
- Malfertheiner P, "Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report", Gut, 56, pp.772~781 (2007)
- Andersson T, "Slow omeprazole metabolizers are also poor S-mephenytoin hydroxylators", Ther Drug Monit, 12, pp.415~416 (1990)
- Andersson T, "Polymorphic hydroxylation of S-mephenytoin and omeprazole metabolism in Caucasian and Chinese subjects", Pharmacogenetics, 2, pp.25~31 (1992)
- Sohn DR, "Disposition kinetics and metabolism of omeprazole in extensive and poor metabolizers of S-mephenytoin 4'-hydroxylation recruited from an Oriental population", J Pharmacol Exp Ther, 262, pp.1195~1202 (1992)
- Kubota T, "Genotyping of S-mephenytoin 4'-hydroxylation in an extended Japanese population", Clin Pharmacol Ther, 60, pp.661~666 (1996)
- Ishizaki T, "Review article: cytochrome P450 and the metabolism of proton pump inhibitors--emphasis on rabeprazole", Aliment Pharmacol Ther, 13(Suppl. 3), pp.27~36 (1999)
- Furuta T, "Effect of genotypic differences in CYP2C19 on cure rates for Helicobacter pylori infection by triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin", Clin Pharmacol Ther, 69, pp.158~168 (2001)
- Take S, "Interleukin-1beta genetic polymorphism influences the effect of cytochrome P 2C19 genotype on the cure rate of 1-week triple therapy for Helicobacter pylori infection", Am J Gastroenterol, 98, pp.2403~2408 (2003)
- Sugimoto M, "Influences of proinflammatory and anti-inflammatory cytokine polymorphisms on eradication rates of clarithromycin-sensitive strains of Helicobacter pylori by tripletherapy", Clin Pharmacol Ther, 80, pp.41~50 (2006)
- Furuta T, "Pharmacogenomicsbased tailored versus standard therapeutic regimen for eradication of H. pylori", Clin Pharmacol Ther, 81, pp.521~528 (2007)
- Kuwayama H, "Rabeprazolebased eradication therapy for Helicobacter pylori: a largescale study in Japan", Aliment Pharmacol Ther, 25, pp.1105~1113 (2007)
- Yang JC, "Pharmacokinetic-pharmacodynamic analysis of the role of CYP2C19 genotypes in short-term rabeprazole-based triple therapy against Helicobacter pylori", Br J Clin Pharmacol, 67, pp.503~510 (2009)
- Padol S, "The effect of CYP2C19 polymorphisms on H. pylori eradication rate in dual and triple first-line PPI therapies: a meta-analysis", Am J Gastroenterol, 101, pp.1467~1475 (2006)
- Zhao F, "Effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitorbased triple therapy for Helicobacter pylori eradication: a meta-analysis", Helicobacter, 13, pp.532~541 (2008)
- Kupfer A, "Pharmacogenetics of mephenytoin: a new drug hydroxylation polymorphism in man", Eur J Clin Pharmacol, 26, pp.753~759 (1984)
- Wedlund PJ, "Mephenytoin hydroxylation deficiency in Caucasians:frequency of a new oxidative drug metabolism polymorphism", Clin Pharmacol Ther, 36, pp.773~780 (1984)
- Horai Y, "Metoprolol and mephenytoin oxidation polymorphisms in Far Eastern Oriental subjects: Japanese versus mainland Chinese", Clin Pharmacol Ther, 46, pp.198~207 (1989)
- Sohn DR, "Incidence of Smephenytoin hydroxylation deficiency in a Korean population and the interphenotypic differences in diazepam pharmacokinetics", Clin Pharmacol Ther, 52, pp.160~169 (1992)
- Pantoflickova D, "Acid inhibition on the first day of dosing: comparison of four proton pump inhibitors", Aliment Pharmacol Ther, 17, pp.1507~1514 (2003)
- Saitoh T, "Effects of rabeprazole, lansoprazole and omeprazole on intragastric pH in CYP2C19 extensive metabolizers", Aliment Pharmacol Ther, 16, pp.1811~1817 (2002)
- Dojo M, "Effects of CYP2C19 gene polymorphism on cure rates for Helicobacter pylori infection by triple therapy with proton pump inhibitor (omeprazole or rabeprazole), amoxycillin and clarithromycin in Japan", Dig Liver Dis, 33, pp.671~675 (2001)
- Inaba T, "Randomized open trial for comparison of proton pump inhibitors in triple therapy for Helicobacter pylori infection in relation to CYP2C19 genotype", J Gastroenterol Hepatol, 17, pp.748~753 (2002)
- Kawabata H, "Effect of different proton pump inhibitors, differences in CYP2C19 genotype and antibiotic resistance on the eradication rate of Helico bacter pylori infection by a 1-week regimen of proton pump inhibitor, amoxicillin and clarithromycin", Aliment Pharmacol Ther, 17, pp.259~264 (2003)
- 박상종, "Rabeprazole을 포함한 3제요법의 헬리코박터 파이로리 제균 효과와 CYP2C19 유전자형의 영향", 대한소화기학회지, 42(6) (2003), 대한소화기학회
- Miki I, "Impact of clarithromycin resistance and CYP2C19 genetic polymorphism on treatment efficacy of Helicobacter pylori infection with lansoprazole-or rabeprazole-based triple therapy in Japan", Eur J Gastroenterol Hepatol, 15, pp.27~33 (2003)
- Hawkey CJ, "Safety and efficacy of 7-day rabeprazole- and omeprazole-based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease", Aliment Pharmacol Ther, 17, pp.1065~1074 (2003)
- Vakil N, "Seven-day therapy for Helicobacter pylori in the United States", Aliment Pharmacol Ther, 20, pp.99~107 (2004)
- Tolman KG, "Comparison of the effects of single and repeated oral doses of lansoprazole and rabeprazole on ambulatory 24-hour intragastric pH in healthy volunteers", Clin Drug Investig, 26, pp.21~28 (2006)
- Shimatani T, "Acid-suppressive effects of rabeprazole, omeprazole, and lansoprazole at reduced and standard doses: a crossover comparative study in homozygous extensive metabolizers of cytochrome P450 2C19", Clin Pharmacol Ther, 79, pp.144~152 (2006)
- Miura M, "Effect of clarithromycin on the enantioselective disposition of lansoprazole in relation to CYP2C19 genotypes", Chirality, 17, pp.338~344 (2005)
