PMID- 21614934
OWN - NLM
STAT- MEDLINE
DCOM- 20110621
LR  - 20201209
IS  - 0027-7622 (Print)
IS  - 0027-7622 (Linking)
VI  - 73
IP  - 1-2
DP  - 2011 Feb
TI  - Improvements in Helicobacter pylori eradication rates through clinical CYP2C19 
      genotyping.
PG  - 25-31
AB  - Lansoprazole (LPZ), amoxicillin (AMPC) and clarithromycin (CAM) are commonly used 
      drugs (LAC regimen) for Helicobacter pylori (H. pylori) eradication, but the 
      eradication rate with this regimen was reported to be 70% to 90%. A few studies 
      have reported that a successful eradication was associated with the CYP2C19 
      genotype, which influences the metabolism of proton pump inhibitors (PPI) 
      including LPZ. This study examined the changes in the H. pylori eradication rates 
      between the periods before and after the commencement of a routine genetic test 
      for CYP2C19 at the Daiko Medical Center in Nagoya, Japan, in November, 2005. 
      Subjects were patients who visited the Center during the period from June, 2004 
      to August, 2010. The patients were classified into three groups according to 
      their CYP2C19 genotype: rapid metabolizers (RM) with a *1*1 genotype, 
      intermediate metabolizers (IM) with a *1*2 or *1*3 genotype, and poor 
      metabolizers (PM) with a *2*2, *2*3, or *3*3 genotype. Non-rapid metabolizers (IM 
      and PM) were basically treated with a LAC regimen, while RMs were treated with a 
      RAM reg imen(rabeprazole, AMPC, and metronidazole). The eradication rate was 
      80.0% (n=90) for the period without the genetic testing and 88.7% (n=124) for the 
      period with the genetic testing (chi2=3.11, p=0.078). The age-sex adjusted odds 
      ratio of eradication success was 2.29 (95% confidence interval, 0.99-5.28, 
      p=0.051) for the latter period relative to the former period among those less 
      than 70 years of age. Those results suggested that the routine genetic test which 
      allows a choice of the RAM regimen for R M improved the eradication rate.
FAU - Tamura, Takashi
AU  - Tamura T
AD  - Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 
      Japan. tamura.takashi@c.mbox.nagoya-u.ac.jp
FAU - Kurata, Mio
AU  - Kurata M
FAU - Inoue, Shigeru
AU  - Inoue S
FAU - Kondo, Takaaki
AU  - Kondo T
FAU - Goto, Yasuyuki
AU  - Goto Y
FAU - Kamiya, Yoshikazu
AU  - Kamiya Y
FAU - Kawai, Sayo
AU  - Kawai S
FAU - Hamajima, Nobuyuki
AU  - Hamajima N
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Japan
TA  - Nagoya J Med Sci
JT  - Nagoya journal of medical science
JID - 0412011
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - 140QMO216E (Metronidazole)
RN  - 32828355LL (Rabeprazole)
RN  - 804826J2HU (Amoxicillin)
RN  - EC 1.14.14.1 (Aryl Hydrocarbon Hydroxylases)
RN  - EC 1.14.14.1 (CYP2C19 protein, human)
RN  - EC 1.14.14.1 (Cytochrome P-450 CYP2C19)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage/pharmacokinetics
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Amoxicillin/administration & dosage
MH  - Aryl Hydrocarbon Hydroxylases/*genetics/metabolism
MH  - Clarithromycin/administration & dosage
MH  - Cytochrome P-450 CYP2C19
MH  - Female
MH  - Genotype
MH  - Helicobacter Infections/*drug therapy/*genetics/metabolism
MH  - *Helicobacter pylori
MH  - Humans
MH  - Japan
MH  - Lansoprazole
MH  - Male
MH  - Metronidazole/administration & dosage
MH  - Middle Aged
MH  - Pharmacogenetics
MH  - Proton Pump Inhibitors/administration & dosage/pharmacokinetics
MH  - Rabeprazole
MH  - Young Adult
EDAT- 2011/05/28 06:00
MHDA- 2011/06/22 06:00
CRDT- 2011/05/28 06:00
PHST- 2011/05/28 06:00 [entrez]
PHST- 2011/05/28 06:00 [pubmed]
PHST- 2011/06/22 06:00 [medline]
PST - ppublish
SO  - Nagoya J Med Sci. 2011 Feb;73(1-2):25-31.