Effect of the CYP2C19 polymorphism on the eradication rate of Helicobacter pylori infection by 7-day triple therapy with regular proton pump inhibitor dosage

J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 1):1287-91. doi: 10.1111/j.1440-1746.2008.05392.x. Epub 2008 Jul 10.

Abstract

Background and aim: Proton pump inhibitors (PPI) are mainly metabolized by cytochrome P450 2C19 (CYP2C19) in the liver. We investigated whether the CYP2C19 genotype plays a role in the eradication rate of Helicobacter pylori (H. pylori) infection in patients receiving pantoprazole- or esomeprazole-based triple therapy.

Methods: A total of 327 patients infected with H. pylori were treated with either pantoprazole or esomeprazole, plus amoxicillin and clarithromycin for 7 days. The presence of the CYP2C19 genotype was determined by pyrosequencing.

Results: The overall H. pylori eradication rate was 85%; 82.6% for the PAC regimen, and 88.3% for the EAC regimen; the differences were not statistically significant. The overall eradication rate in the poor metabolizer groups (PM) was significantly higher than in the extensive metabolizer groups (EM) (97.4% vs 83.3%; P = 0.016). The eradication rates in the EM and PM groups were 80.8% and 95.7% for the PAC regimen and 86.8% and 100% for the EAC regimen, respectively.

Conclusion: The results of this study suggest that the CYP2C19 genotype status may play a role in the H. pylori eradication rate in patients receiving pantoprazole or esomeprazole-based triple therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage
  • Adult
  • Amoxicillin / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Clarithromycin / administration & dosage
  • Cytochrome P-450 CYP2C19
  • Drug Therapy, Combination
  • Esomeprazole / administration & dosage
  • Female
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / genetics*
  • Helicobacter pylori*
  • Humans
  • Male
  • Middle Aged
  • Pantoprazole
  • Polymorphism, Genetic
  • Proton Pump Inhibitors / administration & dosage*
  • Treatment Outcome

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Amoxicillin
  • Pantoprazole
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Clarithromycin
  • Esomeprazole