Korean J Gastroenterol.  2003 Dec;42(6):468-475.

Efficacy of Triple Therapy with Rabeprazole for Helicobacter pylori Infection in relation to CYP2C19 Genotype

• Lee SB
• Park SJ
• Ryu JK
• Lee JK
• Kim HJ
• Bae JS
• Jung HS
• Park SM

Abstract

BACKGROUND/AIMS: Genetic polymorphism of cytochrome P450 CYP2C19 influences the efficacy of proton pump inhibitor (PPI) in Helicobacter pylori (H. pylori) eradication therapy. We investigated the difference in the cure rates of H. pylori infection by triple (rabeprazole plus amoxacillin and clarithromycin) therapy in relation to CYP2C19 genotype status. METHODS: One hundred and sixteen H. pylori infected patients with gastric ulcer and duodenal ulcer completed the triple therapy with 10 mg of rabeprazole b.i.d., 1,000 mg amoxacillin b.i.d. and 500 mg of clarithromycin b.i.d. for one week. The genotype of CYP2C19 was determined by a PCR-restriction fragment length polymorphism method. RESULTS: According to the univariate analysis, heterozygous extensive metabolizers (hetero EMs) and poor metabolizers (PMs) showed the highest (87.0%) and the lowest (80.0%) eradication rates, respectively. The difference in the therapeutic efficacy of rabeprazole among the different CYP2C19 genotypes was insignificant. With regard to gender, age and smoking history in relation to eradication rate, a statistical significance was noted only with age with odds ratio of 1.063 and p-value of 0.0202. CONCLUSIONS: In the eradication therapy of H. pylori, no statistically significant difference in therapeutic efficacy of rabeprazole was found among different CYP2C19 genotypes.

Keyword

CYP2C19; Helicobacter pylori; Proton pump inhibitor; Rabeprazole

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles
Adult
Aged
Amoxicillin/administration & dosage
Anti-Bacterial Agents/administration & dosage
Anti-Ulcer Agents/*administration & dosage
Aryl Hydrocarbon Hydroxylases/*genetics
Benzimidazoles/*administration & dosage
Clarithromycin/administration & dosage
Drug Therapy, Combination
Duodenal Ulcer/drug therapy/*genetics/microbiology
Female
Genotype
Helicobacter Infections/*drug therapy
*Helicobacter pylori
Humans
Male
Middle Aged
Mixed Function Oxygenases/*genetics
Omeprazole/analogs & derivatives
Proton Pumps/*antagonists & inhibitors
Stomach Ulcer/drug therapy/*genetics/microbiology