Concomitant dosing of famotidine with a triple therapy increases the cure rates of <i>Helicobacter pylori</i> infections in patients with the homozygous extensive metabolizer genotype of CYP2C19

Okudaira, Keisuke; Furuta, Takahisa; Shirai, Naohito; Sugimoto, M.; Miura, Soichiro

doi:10.1111/j.1365-2036.2005.02353.x

Cited by 26 publications

(21 citation statements)

References 42 publications

(44 reference statements)

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“…In Asians, treatment with omeprazole plus amoxicillin resulted in 29, 60 and 100% eradication rates in extensive metabolizers, intermediate metabolizers and poor metabolizers, respectively [38]. Similar findings have been independently observed in other trials, after triple-drug combination therapy [41,42].…”

Section: The Cyp2c19 Genesupporting

confidence: 64%

Cytochrome P450 Gene-Based Drug Prescribing and Factors Impacting Translation into Routine Clinical Practice

Wilke

Musana

Weber

2005

Personalized Medicine

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Pharmacogenetics represents a rapidly advancing, competitive field of investigation. Due to the potential for clinically recognizable interactions between a set of old polymorphic genes and a relatively new environmental insult (drugs), many human geneticists believe that variability in the drug-metabolizing enzyme systems will soon translate into clinical practice across entire populations. Despite this, the field has not yet received widespread clinical acceptance. This article will review the common cytochrome P450 gene polymorphisms and discuss the factors that may facilitate (or attenuate) their translation into clinical practice.

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Section: The Cyp2c19 Genesupporting

confidence: 64%

Cytochrome P450 Gene-Based Drug Prescribing and Factors Impacting Translation into Routine Clinical Practice

Wilke

Musana

Weber

2005

Personalized Medicine

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“…Plasma levels and the inhibitory efficacy of PPIs on gastric acid secretion are affected by polymorphisms of CYP2C19, which is a primary enzyme responsible for metabolizing PPIs. The eradication rate is decreased in individuals with the extensive metabolizer genotype of CYP2C19; however, the eradication rate can be improved by using an increased dose of a PPI or adding an H2 receptor antagonist . Moreover, the inhibitory effect of VPZ on gastric acid secretion and the eradication rate with VPZ‐containing regimen are reportedly not affected by CYP2C19 polymorphisms …”

Section: Treatmentmentioning

confidence: 99%

Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition

et al. 2019

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Background Since “Helicobacter pylori (H. pylori) infection” was set as the indication in the Japanese Society for Helicobacter Research (JSHR) Guidelines 2009, eradication treatment for H. pylori gastritis is covered under insurance since 2013 in Japan, and the number of H. pylori eradication has rapidly increased. Under such circumstances, JSHR has made the third revision to the “Guidelines for diagnosis and treatment of H. pylori infection” for the first time in 7 years. Methods The Guideline Committee held 10 meetings. Articles published between the establishment of the 2009 Guidelines and March 2016 were reviewed and classified according to the evidence level; the statements were revised on the basis of this review. After inviting public comments, the revised statements were finalized using the Delphi method. Results There was no change in the basic policy that H. pylori infectious disease is an indication for eradication. Other diseases presumed to be associated with H. pylori infection were added as indications. Serum pepsinogen level, endoscopic examination, and X‐ray examination were added to the diagnostic methods. The effects of 1‐week triple therapy consisting of potassium‐competitive acid blocker (P‐CAB), amoxicillin, and clarithromycin have improved, and high eradication rates can also be expected with proton pump inhibitors (PPI) or P‐CAB combined with amoxicillin and metronidazole. If the susceptibility test is not performed, the triple PPI or P‐CAB/amoxicillin/metronidazole therapy should be chosen, because the PPI/amoxicillin/metronidazole combination demonstrated a significantly higher eradication rate than PPI/amoxicillin/clarithromycin. In the proposal for gastric cancer prevention, we divided gastric cancer prevention measures by age from adolescent to elderly, who are at an increased gastric cancer risk, and presented measures for gastric cancer prevention primarily based on H. pylori eradication. Conclusion We expect the revised guidelines to facilitate appropriate interventions for patients with H. pylori infection and accomplish its eradication and prevention of gastric cancer.

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“…Moreover, CYP2C19 polymorphism is important. Japanese studies have shown that the eradication rates are significantly higher in the poor metabolizers than those of homozygous or heterozygous extensive metabolizers, and the frequency of poor metabolizers is five times greater in Japan than that found in Caucasians [29, 30]. …”

Section: Discussionmentioning

confidence: 99%

Update on Clarithromycin Resistance in <i>Helicobacter pylori</i> in Hong Kong and Its Effect on Clarithromycin-Based Triple Therapy

Xia²,

Wang³

et al. 2006

Digestion

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Aim: To determine the antibiotic susceptibility of Helicobacter pylori and evaluate the efficacy of a clarithromycin-based triple therapy in relation to antibiotic resistance. Methods: Consecutive patients referred for upper endoscopy due to dyspeptic symptoms were recruited. Gastric biopsies were obtained for the CLO test, histology and culture. Antibiotic susceptibility was assessed by the E-test. Patients with H. pylori infection received rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily for 7 days. Results: Of 234 patients recruited, 124 were H. pylori-positive and culture was successful in 102 patients. The updated prevalences of resistance to clarithromycin, amoxicillin and metronidazole were 7.8, 0 and 39.2%, respectively. A total of 86 patients received 1-week triple therapy with rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily, and 81 patients attended the follow-up test. Eradication rates by per-protocol and intention-to-treat analysis were 92.6 and 87.2%, respectively. The eradication rate by per protocol was significantly higher in patients with clarithromycin-susceptible strains than in those with clarithromycin-resistant strains (98.6 vs. 28.6%, p < 0.001). Conclusion: Clarithromycin resistance reduces the clinical efficacy of clarithromycin-based triple therapy. However, due to the low prevalence of clarithromycin resistance, clarithromycin-based therapy is still the first choice for clinical use.

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Concomitant dosing of famotidine with a triple therapy increases the cure rates of Helicobacter pylori infections in patients with the homozygous extensive metabolizer genotype of CYP2C19

Cited by 26 publications

References 42 publications

Cytochrome P450 Gene-Based Drug Prescribing and Factors Impacting Translation into Routine Clinical Practice

Cytochrome P450 Gene-Based Drug Prescribing and Factors Impacting Translation into Routine Clinical Practice

Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition

Update on Clarithromycin Resistance in <i>Helicobacter pylori</i> in Hong Kong and Its Effect on Clarithromycin-Based Triple Therapy

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