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

Shimatani, Tomohiko; Inoue, Masakí; Kuroiwa, Tomoko; Xu, Jing; Mieno, Hiroshi; Nakamura, Masuo; Tazuma, Susumu

doi:10.1016/j.clpt.2005.09.012

Cited by 46 publications

(39 citation statements)

References 61 publications

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“…However, a single dose of not 10 mg but 20 mg rabeprazole was compared among CYP2C19 genotypes. These results slightly differ from those of previous reports [16,[18][19][20]36] in which rabeprazole induced an earlier rise in the intragastric pH than other PPIs. However, most previous studies examined the effects after the administration of 20 mg rabeprazole or other PPIs on days 3 -7 [16,[18][19][20]36], not the early postadministration phase (1 -12 h) of a single dose.…”

Section: Discussioncontrasting

confidence: 57%

“…The acid-inhibitory effects of PPIs are significantly dependent on the genotype status, as well as on their intrinsic pharmacokinetic and pharmacodynamic charac-teristics and dosing schemes [10,[17][18][19][20]. The effect of omeprazole on the suppression of gastric acid secretion was related to the area under the time-plasma concentration curve (AUC) [21,22].…”

Section: Introductionmentioning

confidence: 99%

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Influence of the Meal and Genotype of CYP2C19 on the Pharmacokinetics of Proton Pump Inhibitors in Healthy Japanese Subjects

Shinkai¹,

Koike²,

Shimada³

et al. 2013

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Objectives: To evaluate the influence of meals on the pharmacokinetics of omeprazole and rabeprazole and to investigate these PPIs with reference to CYP2C19 genotypes in healthy Japanese men. Methods: This was a randomized, open label, four-way crossover study. Twelve healthy Japanese male volunteers received a single oral dose of either 20 mg omeprazole or 10 mg rabeprazole, in the fasted state and after a standardized breakfast. Results: Between the administration of omeprazole in the fasted state and after breakfast, there were no significant differences in Cmax, AUC, Tmax, and half-life. Between the administration of rabeprazole in the fasted state and after breakfast, there were no significant differences in Cmax, AUC and half-life, whereas the Tmax of rabeprazole after breakfast was significantly delayed (2.8 ± 1.0 vs 5.3 ± 1.8 h, respectively; p = 0.006). PMs demonstrated the highest Cmax and AUC after drug intake under the fasting state and after breakfast, and homo EMs showed a significantly delayed Tmax. Conclusion: When a single dose of either PPI was administered, the pharmacokinetics of omeprazole was not affected by the meal, whereas the Tmax of rabeprazole after the meal was significantly delayed.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Influence of the Meal and Genotype of CYP2C19 on the Pharmacokinetics of Proton Pump Inhibitors in Healthy Japanese Subjects

Shinkai¹,

Koike²,

Shimada³

et al. 2013

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“…Achieving sufficient gastric acid secretion-inhibiting effects is important, and a correlation is thought to exist between gastric pH and the success of H. pylori eradication therapy (14). RPZ is known to increase gastric pH to between 6 and 8 more rapidly and reliably than other PPIs and to effectively inhibit nocturnal secretion of gastric acid (15)(16)(17)(18)(19). The CYP2C19 genotype is also known to be a factor that affects the eradication rate (20).…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Prospective Observational Study of Triple Therapy with Rabeprazole, Amoxicillin and Metronidazole for <i>Helicobacter pylori</i> in Japan

et al. 2012

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Objective Triple therapy with rabeprazole (RPZ), amoxicillin (AMPC) and metronidazole (MNZ) (RPZ+ AMPC+MNZ therapy: RAM therapy) has been approved by the Japanese Ministry of Health, Labour and Welfare as a second-line therapy for Helicobacter pylori-positive gastric and duodenal ulcers in Japan. The present multicenter prospective observational study aimed to investigate the safety and efficacy of RAM therapy in clinical practice. Methods Patients with H. pylori-positive gastric or duodenal ulcers (including ulcer scars) in whom firstline therapy was unsuccessful were administered 10 mg of RPZ, 750 mg of AMPC and 250 mg of MNZ twice daily for seven days (total: 14 doses) based on an approved dose and regimen. Patient background factors, including complications, previous medical history, concomitant drugs, eradication results and adverse events were recorded by the investigator. Results The incidence of adverse drug reactions was 2.21% and the H. pylori eradication rate was 92.8%. Subgroup analyses performed to investigate the patient background factors affecting safety and efficacy revealed no factors that significantly affected the incidence of adverse drug reactions or the H. pylori eradication rate. Conclusion Amid reports of decreased eradication rates with clarithromycin-based first-line therapy, the >90% H. pylori eradication rate achieved in the present study demonstrates the clinical efficacy of RAM therapy in subjects in whom first-line therapy is unsuccessful.

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“…31 The median values of the 24-hour percent time for pH＞4 of HomEM were 59% in 20 mg rabeprazole and 56% in 30 mg lansoprazole. 32 There were 3 clinical studies 25,26,28 that directly compared H. pylori eradication rates of lansoprazole and rabeprazole according to CYP2C19 polymorphism. Although these studies had relatively small sample size and insufficient randomization, they all reported no significant differences of eradication rate between lansoprazole and rabeprazole group according to each CYP2C19 polymorphism.…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Jung²,

Choi³

et al. 2010

Gut Liver

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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 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.

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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

Cited by 46 publications

References 61 publications

Influence of the Meal and Genotype of CYP2C19 on the Pharmacokinetics of Proton Pump Inhibitors in Healthy Japanese Subjects

Influence of the Meal and Genotype of CYP2C19 on the Pharmacokinetics of Proton Pump Inhibitors in Healthy Japanese Subjects

A Multicenter Prospective Observational Study of Triple Therapy with Rabeprazole, Amoxicillin and Metronidazole for <i>Helicobacter pylori</i> in Japan

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

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