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The effect of cytochrome P2C19 and interleukin-1 polymorphisms on H. pylori eradication rate of 1-week triple therapy with omeprazole or rabeprazole, amoxycillin and clarithromycin in Chinese people.

Author(s): Zhang L, Mei Q, Li QS, Hu YM, Xu JM

Affiliation(s): Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China.

Publication date & source: 2010-12, J Clin Pharm Ther., 35(6):713-22.

Publication type: Randomized Controlled Trial

WHAT IS KNOWN AND OBJECTIVE: Genetic polymorphism of interleukin (IL)-1beta and IL-1 receptor antagonist (IL-1ralpha) are associated with efficacy of acid suppression, whereas cytochrome P (CYP) 2C19 polymorphism influences the metabolism of proton pump inhibitor family. Thus, CYP2C19 and IL-1 polymorphisms may affect the efficacy of H. pylori eradication therapy. We compared the efficacies of omeprazole and rabeprazole on eradication of H. pylori in relation to CYP2C19, IL-1B and IL-1RN genotypes in Chinese people. METHODS: Two hundred and forty Chinese with peptic ulcer disease were randomly assigned to the following regimens: amoxicillin and clarithromycin together with omeprazole (OAC) or rabeprazole (RAC). CYP2C19*2 and *3, IL1B-511, IL1B-31, IL1B+ 3954 and intron 2 of the IL-1RN genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: The intention-to-treat-based cure rate of the OAC regimen was significantly lower than that of the RAC regimen in the CYP2C19 wild-type homozygotes (P = 0.014). No significant differences in the cure rates were observed among the IL-1RN and the IL-1B genotype groups. WHAT IS NEW AND CONCLUSIONS: The rabeprazole-based triple regimen was better than the omeprazole in Chinese patients with the CYP2C19 extensive metabolizer genotype. The effectiveness of the PPI/AC regimen is unrelated to IL-1B and IL1-RN genetic polymorphism. (c) 2010 Blackwell Publishing Ltd.

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