Effect of genetic differences in omeprazole metabolism on cure rates for Helicobacter pylori infection and peptic ulcer.

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Furuta T, Ohashi K, Kamata T, Takashima M, Kosuge K, Kawasaki T, Hanai H, Kubota T, Ishizaki T, Kaneko E

Effect of genetic differences in omeprazole metabolism on cure rates for Helicobacter pylori infection and peptic ulcer.

Ann Intern Med. 1998 Dec 15;129(12):1027-30.

PubMed ID

9867757 [ View in PubMed

]

Abstract

BACKGROUND: Omeprazole is metabolized by S-mephenytoin 4'-hydroxylase (CYP2C19) in the liver. In persons with a poor-metabolizer genotype for CYP2C19, the therapeutic efficacy of omeprazole may be increased. OBJECTIVE: To investigate whether CYP2C19 genotype status is associated with cure rates for Helicobacterpylori infection and peptic ulcer achieved by using dual therapy with omeprazole and amoxicillin. DESIGN: Prospective cohort study. SETTING: University hospital and health service center in Hamamatsu, Japan. PATIENTS: 62 patients with peptic ulcer and H. pylori infection. INTERVENTION: Omeprazole and amoxicillin. MEASUREMENTS: CYP2C19 genotype status and cure rates for H. pylori infection and peptic ulcer. RESULTS: Cure rates for H. pylori infection were 28.6% (95% CI, 13.1% to 48.7%), 60% (CI, 38.6% to 83.0%), and 100% (CI, 66.4% to 100%) in the rapid-, intermediate-, and poor-metabolizer groups, respectively. Healing rates for both duodenal and gastric ulcer in the three groups were roughly parallel with cure rates for H. pylori infection. CONCLUSION: The results of the genotyping test for CYP2C19 seem to predict cure of H. pylori infection and peptic ulcer in patients who receive dual therapy with omeprazole and amoxicillin.

DrugBank Data that Cites this Article

Pharmaco-genomics

Drug	Interacting Gene/Enzyme	Allele name	Genotypes	Defining change(s)	Type(s)	Description	Details
Omeprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2	(A;A)	A Allele, homozygote (rs4244285)	Effect Directly Studied	Patients with this genotype have reduced metabolism of omeprazole.	Details
Omeprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	(A;A)	A Allele, homozygote (rs4986893)	Effect Directly Studied	Patients with this genotype have reduced metabolism of omeprazole.	Details
Lansoprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2	(A;A)	A Allele, homozygote (rs4244285)	Effect Directly Studied	Patients with this genotype have reduced metabolism of lansoprazole.	Details
Lansoprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	(A;A)	A Allele, homozygote (rs4986893)	Effect Directly Studied	Patients with this genotype have reduced metabolism of lansoprazole.	Details
Esomeprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*2	(A;A)	A Allele, homozygote (rs4244285)	Effect Directly Studied	Patients with this genotype have reduced metabolism of esomeprazole.	Details
Esomeprazole	Cytochrome P450 2C19 Gene symbol: CYP2C19 UniProt: P33261	CYP2C19*3	(A;A)	A Allele, homozygote (rs4986893)	Effect Directly Studied	Patients with this genotype have reduced metabolism of esomeprazole.	Details