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KMID : 0931320080080010015
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대한상부위장관.헬리코박터학회지
2008 Volume.8 No. 1 p.15 ~ p.19
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Influence of CYP2C19 Polymorphism on Eradication of Helicobacter pylori: Comparison between Pantoprazole Based First-line and Rabeprazole Based Second-line Therapy
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Chung Jun-Won
Lee Gin-Hyug
Kim Jin-Ho
Jung Hwoon-Yong
Choi Kee-Don
Choi Kwi-Sook
Kim Do-Hoon
Jung Kee-Wook
Song Ho-June
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Abstract
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Background/Aims: Genetic polymorphism of CYP2C19 could influence the eradication rate with PPI-based regimen. This study was conducted to evaluate the relationship between CYP2C19 polymorphism and the eradication rate of first- or second-line regimen in Korean patients.
Methods: Fifty patients completed triple therapy with 40 mg of pantoprazole, 1,000 mg amoxicillin, and 500 mg of clarithromycin twice daily for one week. The genotype of CYP2C19 was determined by melting point genotyping methods. Twenty four patients who failed first line therapy were also included. The second-line regimen was as follows: amoxicillin 1,000 mg bid, metronidazole 500 mg bid, tetracycline 500 mg qid, bismuth 600 mg bid, and rabeprazole 20 mg bid for 1 week.
Results: Overall eradication rate of first-line triple therapy was 74.0% (37/50). Eradication rates for first-line therapy in poor metabolizer, heterozygous extensive metabolizer (EM) and homozygous EM were 66.7% (4/6), 77.3% (17/22) and 72.7% (16/22), respectively (p=0.86). The overall cure rate of second-line regimen was 75.0% (18/24). Eradication rates were 100% (2/2), 66.6% (8/12), and 80.0% (8/10) in poor metabolizer, heterozygous EM and homozygous EM, respectively (p=1.00).
Conclusions: Eradication rates of Helicobacter pylori were not different between the CYP2C19 genotypes from this limited data. However, prospective study should be performed to prove this result.
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KEYWORD
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CYP2C19, Proton pump inhibitor, Helicobacter pylori, Pantoprazole, Rabeprazole
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