Effect of CYP2C19 Genetic Polymorphisms on the Efficacy of Proton Pump Inhibitor‐Based Triple Therapy for <i>Helicobacter pylori</i> Eradication: A Meta‐Analysis

Zhao, Fu-Jun; Wang, Jing; Yang, Yanmei; Wang, Xiaoyong; Shi, Ruihua; Xu, Zekuan; Huang, Zhibin; Zhang, Guoxin

doi:10.1111/j.1523-5378.2008.00643.x

Cited by 110 publications

(79 citation statements)

References 43 publications

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“…A sub-analysis of CYP2C19 influence on H. pylori eradication by individual PPI found significantly lower rate of eradication for NM compared to IM or PM for omeprazole and lansoprazole; this effect was not significant when esomerazole or rabeprazole were analyzed. Results of this meta-analysis were in line with another meta-analysis by Zhao et al [72], also documenting that patients with NM have lower odds of H. pylori eradication compared to IM and PM. The nonsignificant results for CYP2C19 effect on therapeutic outcomes of rabeprazole and esomeprazole in this meta-analysis and few other studies [71,73] can be explained by the lower contribution of CYP2C19 in esomeprazole and rabeprazole metabolism compared to other PPIs.…”

Section: Cyp2c19 and Ppi Pharmacogeneticssupporting

confidence: 89%

Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine

Rouby

Lima

Johnson

2018

Expert Opinion on Drug Metabolism & Toxicology

181

172

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Introduction: Proton Pump inhibitors (PPIs) are commonly used for a variety of acid related disorders. Despite the overall effectiveness and safety profile of PPIs, some patients do not respond adequately or develop treatment related adverse events. This variable response among patients is in part due to genotype variability of CYP2C19, the gene encoding the CYP450 (CYP2C19) isoenzyme responsible for PPIs metabolism.Areas covered: This article provides an overview of the pharmacokinetics and mechanism of action of the currently available PPIs, including the magnitude of CYPC19 contribution to their metabolism. Additionally, the role of CYP2C19 genetic variability in the therapeutic effectiveness or outcomes of PPI therapy is highlighted in details, to provide supporting evidence for the potential value of CYP2C19 genotype-guided approaches to PPI drug therapy.Expert opinion: There is a large body of evidence describing the impact of CYP2C19 variability on PPIs and its potential role in individualizing PPI therapy, yet, CYP2C19 pharmacogenetics has not been widely implemented into clinical practice. More data are needed but CYP2C19 genotype-guided dosing of PPIs is likely to become increasingly common and is expected to improve clinical outcomes, and minimize side effects related to PPIs.

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Section: Cyp2c19 and Ppi Pharmacogeneticssupporting

confidence: 89%

Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine

Rouby

Lima

Johnson

2018

Expert Opinion on Drug Metabolism & Toxicology

181

172

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“…In additional subanalysis of individual PPIs revealed that omeprazole was influenced by the CYP2C19 genotype [143] . In another meta-analysis, successful eradication rates differed considerably between PM and HetEM (OR = 1.73, P = 0.002) and between PM and HomEM (OR = 2.79, P < 0.0001) and even between HetEM and HomEM (OR = 2.00, P < 0.0001) [144] . This study showed that…”

Section: Is Tailored Therapy On the Horizon For H Pylori Treatment?mentioning

confidence: 96%

“…South Korea Choi et al [189] a regimen including rabeprazole was not affected by CYP2C19 genotype status [144] . According to a metaanalysis of a RCT in 2013, regardless of the PPI being taken, the eradication rates of PM were higher than HetEM and HomEM [145] .…”

Section: Publication Treatment Duration Patients Therapy Regimen Eradmentioning

confidence: 98%

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Kim

Choi

Chung

2015

WJGPT

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Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori ) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Core tip: This article reviews the recent literature describing antibiotic resistance and trends in Helicobacter pylori (H. pylori ) treatment. As there is no effective conventional therapy, new treatments are being developed and bismuth quadruple, sequential, concomitant therapies are recommended as a first-line regimen in regions with high levels of clarithromycin resistance. Quinolones have also been used for H. pylori treatment, although the cure rate has gradually reduced with this approach. New therapeutic directions include probiotic supplementation, tailored therapy, novel agents, and nanotechnology.

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“…The metaanalysis and reviews revealed that metabolism of different drugs like proton pump inhibitors has little association with CYP2C19 genotype [35][36] . Study also suggests that the dose of few drugs can be increased in populations with high frequencies of HomEMs or HetEMs 37 .…”

Section: Discussionmentioning

confidence: 94%