PMID- 23646118
OWN - NLM
STAT- MEDLINE
DCOM- 20131126
LR  - 20220408
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 4
DP  - 2013
TI  - Effects of CYP2C19 loss-of-function variants on the eradication of H. pylori 
      infection in patients treated with proton pump inhibitor-based triple therapy 
      regimens: a meta-analysis of randomized clinical trials.
PG  - e62162
LID - 10.1371/journal.pone.0062162 [doi]
LID - e62162
AB  - BACKGROUND: There are inconsistent conclusions about whether CYP2C19 variants 
      could affect H. pylori eradication rate in patients treated with the proton pump 
      inhibitor (PPI)-based therapy. We therefore performed a meta-analysis of 
      randomized clinical trials (RCTs) to re-evaluate the impact of CYP2C19 variants 
      on PPI-based triple therapy for the above indication. METHODS: All relevant RCTs 
      in the PubMed, Cochrane Library, EMBASE, Web of Science and two Chinese databases 
      (up to February 2013) were systematically searched, and a pooled analysis was 
      performed with the odds ratio (OR) and 95% confidence interval (CI) by the STATA 
      software. RESULTS: Sixteen RCT datasets derived from 3680 patients were included. 
      There was no significant heterogeneity across the data available in this 
      meta-analysis. There were significant differences in that rate between homozygous 
      (HomEMs) and heterozygous (HetEMs) extensive metabolizers (OR 0.724; 95% CI 
      0.594-0.881), between HomEMs and poor metabolizers (PM) (OR 0.507; 95%CI 
      0.379-0.679), or between HetEMs and PMs (OR 0.688; 95%CI 0.515-0.920), regardless 
      of the PPI being taken. Furthermore, sub-analysis of individual PPIs was carried 
      out to explore the difference across all the PPIs used. A significantly low rate 
      was seen in HomEMs vs. HetEMs taking either omeprazole (OR 0.329; 95%CI 
      0.195-0.553) or lansoprazole (OR 0.692; 95%CI 0.485-0.988), and also in HomEMs 
      vs. PMs for omeprazole (OR 0.232; 95%CI 0.105-0.515) or lansoprazole (OR 0.441; 
      95%CI 0.252-0.771). However, there was no significant difference between HetEMs 
      and PMs taking either one. No significant differences were observed for 
      rabeprazole or esomeprazole across the CYP2C19 genotypes of interest. 
      CONCLUSIONS: Carriage of CYP2C19 loss-of-function variants is associated with 
      increased H. pylori eradication rate in patients taking PPI-based triple 
      therapies when omeprazole or lansoprazole is chosen. However, there is no a class 
      effect after use of rabeprazole or esomeprazole.
FAU - Tang, Hui-Lin
AU  - Tang HL
AD  - Department of Pharmacy, Peking University Therapeutic Drug Monitoring and 
      Clinical Toxicology Center, Peking University Third Hospital, Beijing, China.
FAU - Li, Yan
AU  - Li Y
FAU - Hu, Yong-Fang
AU  - Hu YF
FAU - Xie, Hong-Guang
AU  - Xie HG
FAU - Zhai, Suo-Di
AU  - Zhai SD
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20130430
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
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)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Aryl Hydrocarbon Hydroxylases/*genetics/metabolism
MH  - Cytochrome P-450 CYP2C19
MH  - Drug Therapy, Combination
MH  - *Genetic Variation
MH  - Genotype
MH  - Helicobacter Infections/*drug therapy/*genetics/microbiology
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Odds Ratio
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
PMC - PMC3639978
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/05/07 06:00
MHDA- 2013/12/16 06:00
PMCR- 2013/04/30
CRDT- 2013/05/07 06:00
PHST- 2012/12/31 00:00 [received]
PHST- 2013/03/18 00:00 [accepted]
PHST- 2013/05/07 06:00 [entrez]
PHST- 2013/05/07 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2013/04/30 00:00 [pmc-release]
AID - PONE-D-13-00416 [pii]
AID - 10.1371/journal.pone.0062162 [doi]
PST - epublish
SO  - PLoS One. 2013 Apr 30;8(4):e62162. doi: 10.1371/journal.pone.0062162. Print 2013.