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CYP2C19 genotype–related efficacy of omeprazole for the treatment of infection caused by Helicobacter pylori
Author(s) -
Tanigawara Yusuke,
Aoyama Nobuo,
Kita Tomoko,
Shirakawa Katsuro,
Komada Fusao,
Kasuga Masato,
Okumura Katsuhiko
Publication year - 1999
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/s0009-9236(99)70017-2
Subject(s) - omeprazole , cyp2c19 , clarithromycin , amoxicillin , helicobacter pylori , proton pump inhibitor , genotype , gastroenterology , medicine , antibiotics , genotyping , pharmacology , microbiology and biotechnology , biology , cytochrome p450 , gene , genetics , metabolism
Objectives Omeprazole is used for the treatment of infection caused by Helicobacter pylori , and it is metabolized by the polymorphic cytochrome P4502C19 (CYP2C19). We have found that the anti– H pylori efficacy by the combination of omeprazole and antibiotics is related to the CYP2C19 genotype. Methods One hundred eight patients with cultured H pylori –positive gastritis or peptic ulcer were treated with three regimens: quadruple treatment without proton pump inhibitors (n = 25), dual treatment with omeprazole and amoxicillin (INN, amoxicilline) (n = 26), and triple treatment with omeprazole, amoxicillin, and clarithromycin (n = 57). The CYP2C19 genotype was determined by the polymerase chain reaction– restriction fragment length polymorphism (PCR‐RFLP) method and the assessment of the eradication of H pylori was based on all negative examinations, including culture, histology, and 13 C‐urea breath test. Results The eradication rates for the extensive metabolizers were 50% and 86% for the dual and triple treatments, respectively. In contrast, all of the poor metabolizers treated with omeprazole and antibiotics (n = 15) showed an eradication of H pylori . Conclusion The anti– H pylori effect of dual treatment is highly efficient for CYP2C19 poor metabolizers, which suggests that clarithromycin is not necessary as a first line of therapy for this type of patients. Genotyping can provide a choice for the optimal regimen based on individual CYP2C19 genotype. Clinical Pharmacology & Therapeutics (1999) 66 , 528–534; doi: