Therapeutic effects of 10 mg/day rabeprazole administration on reflux esophagitis was not influenced by the CYP2C19 polymorphism

Abstract

The therapeutic effects of 10 mg/day RPZ administration on RE may be uninfluenced by the CYP2C19 polymorphism.

Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine

“…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. Specifically, rabeprazole is predominantly metabolized via nonenzymatic clearance.…”

“…While many studies suggest this to be true regardless of the PPI used, some reports have suggested that the therapeutic outcomes are less influenced by genotype in PPIs with less dependence on CYP2C19 metabolism, namely rabeprazole and esomeprazole [71,73,80]. Nonetheless, other studies suggest CYP2C19 is important for all PPIs.…”

“…Additionally, while the CYP2C19 - inferred metabolic phenotype was consistently associated with acid suppression and therapeutic outcomes for PPIs with extensive CYP2C19 metabolism, it is not always the case with esomeprazole and rabeprazole. While some studies have documented genotype dependent differences in acid suppression and outcomes, others showed no relation between genotype and degree of acid suppression or outcomes for rabeprazole and esomeprazole [40,48,53,71,73,108]. This may be attributed in part to their lesser dependence on CYP2C19 metabolism, the higher potency of these PPIs [53,109,110], compared to other PPIs, lack of *17 testing [71], or combination of these factors, leading to diminished differences between the different CYP2C19 metabolizer phenotypes.…”

Collagenous Colitis Associated with Rabeprazole in a Peritoneal Dialysis Patient

“…In particular, rabeprazole offers rapid effects against gastroesophageal reflux disease. Furthermore, rabeprazole is considered safer than omeprazole or lansoprazole, because the effects of rabeprazole against gastroesophageal reflux disease are not influenced by CYP2C19 polymorphism (9). Many cases of collagenous colitis in hemodialysis patients have been attributed to lansoprazole.…”

Treatment Strategy for Standard-Dose Proton Pump Inhibitor-Resistant Reflux Esophagitis

“…4%) excessive esophageal acid exposure. Endoscopic healing can be achieved in 90 100 and 80 85% of patients with mild and severe reflux esophagitis, respectively, by standarddose oral PPI therapy, which is the first-line treatment for GERD 2,3 . However, according to a report in 2015, the endoscopic healing rate by PPI (primarily standard-dose PPI) therapy decreased to about 70 and 60% in grade C and grade D reflux esophagitis, respectively, based on the LA classification, and the prevalence of severe reflux esophagitis that cannot be healed with standard-dose PPI is increasing 4 .…”