03 June 2017 : Clinical Research
Effect of CYP2C19 Gene Polymorphisms on Proton Pump Inhibitor, Amoxicillin, and Levofloxacin Triple Therapy for Eradication of Helicobacter PyloriYun-An Lin1ABCDEF, Hong Wang1ABCDEFG*, Zhu-Jun Gu1ABCDEF, Wen-Jia Wang1BCDEF, Xiao-Yan Zeng1BCDEF, Yan-Lei Du1BCDEF, Song-Song Ying1EF, Bo-Hua Zhang1EF
Med Sci Monit 2017; 23:2701-2707
BACKGROUND: The effects of PPI are variable owing to the CYP2C19 polymorphisms. However, whether the polymorphisms could affect the Hp eradication efficacy of triple therapy is still not clear. The present study aimed to assess the effects of CYP2C19 gene polymorphisms on proton pump inhibitor (PPI), amoxicillin, and levofloxacin triple therapy for Helicobacter pylori (Hp) eradication.
MATERIAL AND METHODS: We randomly assigned 160 Hp-positive patients with chronic gastritis to 2 groups to receive either 20 mg bid omeprazole (OAL group, n=80) or 10 mg bid rabeprazole (RAL group, n=80), combined with 1000 mg bid amoxicillin and 500 mg qd levofloxacin. The 2 groups were treated for 10 days. The CYP2C19 genotypes included wild-type, M1 mutant gene (*2, the mutation of exon 5), and M2 mutant gene (*3, the mutation of exon 4) identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFIP). According to CYP2C19 genotype combinations, the patients were divided into extensive metabolizer (EM), intermediate metabolizer (IM), and poor metabolizer (PM) subgroups. The eradication efficacy of Hp was evaluated by 14C-UBT at 28 days after treatment.
RESULTS: The trial was completed by 155 patients. Hp eradication rates in OAL and RAL groups were 78.2% and 88.3%, respectively, on per-protocol (PP) analysis, indicating no significant difference (P>0.05). Regarding CYP2C19 genotypes, eradication rates of 60.7%, 84.2%, and 100% were obtained for EM, IM, and PM subgroups, respectively, of the OAL group. EM group eradication rates were significantly lower than IM and PM group values (P<0.05). In the RAL group, no such difference was observed (P>0.05). Hp eradication rates were significantly lower in the EM subgroup of the OAL group compared with that of the RAL group.
CONCLUSIONS: Hp eradication rates were higher in the RAL group than in OAL-treated patients. Interestingly, omeprazole-based therapy was significantly affected by the CYP2C19 genotype, unlike the rabeprazole-based therapy.
Keywords: Amoxicillin, Helicobacter pylori, Levofloxacin, proton pump inhibitors
04 June 2022 : EditorialEditorial: Acute Hepatitis of Unknown Origin in Children. Is Autoimmunity at Play?
Med Sci Monit 2022; 28:e937371
23 Jun 2022 : Clinical ResearchA Real-World Study to Compare the Safety and Efficacy of Paritaprevir/Ombitasvir/Ritonavir and Dasabuvir, w...
Med Sci Monit In Press; DOI: 10.12659/MSM.936706
22 Jun 2022 : Clinical ResearchA Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Offi...
Med Sci Monit In Press; DOI: 10.12659/MSM.937316
21 Jun 2022 : Clinical ResearchOptimal Timing and Outcomes of Minimally Invasive Approach in Acute Biliary Pancreatitis
Med Sci Monit In Press; DOI: 10.12659/MSM.937016
Most Viewed Current Articles
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996