CYP2C19 polymorphism has no influence on rabeprazole-based hybrid therapy forHelicobacter pylorieradication

Abstract

AIMTo evaluate the impact of cytochrome P450 2C19 (CYP2C19) and interleukin-1β (IL-1β) polymorphisms on the efficacy of Helicobacter pylori (H. pylori) eradication by using rabeprazole-based hybrid therapy.METHODSA total of 88 H. pylori-infected patients were recruited to receive 14-d of hybrid therapy from March 2013 to May 2014. Three patients were excluded from analysis because of incomplete compliance. Either a follow-up endoscopy or 13C-urea test was performed to determine the results of H. pylori eradication therapy. The genotypes of CYP2C19 and IL-1β were analyzed to investigate the impact on treatment effect.RESULTSThe total eradication rate of H. pylori was 92.94% (79/85). According to the CYP2C19 genotypes, the rates of H. pylori eradication were 89.19% in extensive metabolizers (EM) and 95.83% in non-EM. The H. pylori eradication rates regarding the IL-1β genotypes were 92.59% in the normal acid secretion group and 93.10% in the low acid secretion group. After multivariable logistic regression analysis, both the genotypes of CYP2C19 and IL-1β had no significant influences on the eradication rates of H. pylori.CONCLUSIONThe CYP2C19 and IL-1β polymorphisms are not significantly independent factors of H. pylori eradication using rabeprazole-based hybrid therapy.

Personalized therapy for Helicobacter pylori: CYP2C19 genotype effect on first‐line triple therapy

“…Efficacy at 14-day regimen was similar to 10-day regimen found in this study (ITT 92.94%), 57 another alternative would be to use vonoprazan, whose metabolism is independent of CYP2C19. 58 One main obstacle is not available in Colombia.…”

“…An example is a recent study described that rabeprazole‐based hybrid therapy was used to surpass CYP2C19 genotype's effect and H pylori sensitivity to antibiotics. Efficacy at 14‐day regimen was similar to 10‐day regimen found in this study (ITT 92.94%), another alternative would be to use vonoprazan, whose metabolism is independent of CYP2C19 . One main obstacle is not available in Colombia.…”

Rabeprazole‐amoxicillin dual therapy as first‐line treatment for H pylori eradication in special patients: A retrospective, real‐life study

“…Rabeprazole was introduced to the dual regimen because it was less likely to interact with other drugs, such as clopidogrel, warfarin, and tacrolimus, due to its cytochrome P450 2C19 (CYP2C19) polymorphism. CYP2C19 and IL‐1β polymorphisms are not significant independent factors of H pylori eradication using rabeprazole‐based hybrid therapy 29 . Rabeprazole has also been reported to possess potential antibacterial properties in an in vitro study 30 .…”

Helicobacter pylori antibiotic resistance profile in Chinese children with upper gastrointestinal symptoms and a literature review for developing personalized eradicating strategies

“…Research on Chinese children showed that the proportions of EM, IM, and PM are 38.04%–49.1%, 40.2%–53%, and 10%–10.7%, respectively ( Zhang et al, 2020 ; Zhou et al, 2020 ; Luo et al, 2023 ). Extensive metabolism may cause the failure of omeprazole triple therapy to eradicate H. pylori, but does not substantially impact rabeprazole triple therapy ( Kuo et al, 2014 ; Lin et al, 2018 ). Similar conclusions were reported in another study, where the eradication rates of the EM, IM, and PM groups were 60.7%, 84.2%, and 100%, respectively, when the same antibacterial drug was used in combination with omeprazole, whereas this difference did not occur in combination treatment with rabeprazole ( Lin et al, 2017 ).…”