Effect of CYP2C19 Polymorphism on Treatment Success in Lansoprazole-Based 7-Day Treatment Regimen for Cure of H. pylori Infection in Japan

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概要

• 論文の詳細を見る

• Recently, Helicobacter pylori (H. pylori)-positive peptic ulcer patients were treated by a 1-week triple therapy [lansoprazole (LPZ) 30 mg, amoxicillin 750 mg and clarithromycin 200 or 400 mg, each twice daily] without the checking CYP2C19 genotype in Japan. This regimen was done to obtain sufficient cure rates for H. pylori infection using a high dose of LPZ (60 mg/day) without the great cost of having to determine the genotype. However, the failure rate for eradicating H. pylori was reported to be 12.5%. The reasons for this were studied in 33 Japanese patients with H. pylori-positive gastric or duodenal ulcer. Blood samples of the patients were collected to determine the genotype of CYP2C19 and plasma concentrations of LPZ and its metabolites at 3 h postdose on the morning of the 7th day of treatment. H. pylori infection was cured in 25 of the 33 patients (75.8%). The cure rate was highest in the group of poor metabolizers (PM), intermediate in the group of extensive metabolizers of the heterozygous type (htEM) and lowest in the group of extensive metabolizers of the homozygous type (hmEM). The relative ratio of mean plasma concentration for LPZ among the 3 groups was 1.00:1.43:2.93 (hmEM:htEM:PM groups). Our data suggest that success of the eradication is dependent on the CYP2C19-related genotypic status or the plasma concentrations of LPZ in a steady state condition after a multiple dosing regimen; that is to say, checking CYP2C19 is necessary even on occasions when treatment is done by H. pylori eradication methods as performed in Japan.

• 鳥取大学の論文

著者

• Murawaki Yoshikazu

  鳥取大学 医学部統合内科医学講座機能病態内科学

• Murawaki Yoshikazu

  Tottori Univ. Fac. Medicine Yonago Jpn

• Maeda Naoto

  Tottori Univ. Fac. Medicine Yonago Jpn

• Miura Norimasa

  Div. Of Pharmacotherapeutics Dep. Of Pathophysiological And Therapeutic Sci. Fac. Of Medicine Tottor

• Junichi Hasegawa

  Division Of Pharmacotherapeutics Department Of Pathophysiological And Therapeutic Science Faculty Of Medicine Tottori University

関連論文

• Spatial and chronological differences in hepatitis B virus genotypes from patients with acute hepatitis B in Japan
• Effect of CYP2C19 Polymorphism on Treatment Success in Lansoprazole-Based 7-Day Treatment Regimen for Cure of H. pylori Infection in Japan
• Effects of Hesperidin on the Progression of Hypercholesterolemia and Fatty Liver Induced by High-Cholesterol Diet in Rats

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