Abstract
CYP2C19 polymorphisms and smoking influence the efficacy of H. pylori eradication therapy, but interaction between the two have hitherto not been examined. A total of 142 H. pylori-positive patients who received triple drug therapy with lansoprazole, amoxicillin and clarithromycin were categorized into three groups with regard to diplotypes of CYP2C19: homozygous extensive metabolizer (homEM), heterozygous EM (hetEM), and poor metabolizer (PM). The overall success rate was 61.3%. Smoking was an independent risk factor of eradication failure (OR 2.81, 95% CI 1.14-6.91), whereas CYP2C19 polymorphisms were less influential. Among non-smokers, the homEM and hetEM groups showed worse eradication rates (58.5 and 67.3%) relative to PM (76.2%) as expected; however, an opposite trend was observed among smokers (homEM 50.0%, hetEM 46.7%, PM 20.0%), indicating possible interactions with CYP2C19 polymorphisms. Smoking has a greater influence on H. pylori eradication than the CYP2C19 genotype. Interaction between smoking and CYP2C19 should be examined in the future.
MeSH terms
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2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage
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2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use
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Adult
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Aged
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Amoxicillin / administration & dosage
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Amoxicillin / therapeutic use
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / therapeutic use
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Anti-Ulcer Agents / administration & dosage
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Anti-Ulcer Agents / therapeutic use
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Aryl Hydrocarbon Hydroxylases / genetics*
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Clarithromycin / administration & dosage
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Clarithromycin / therapeutic use
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Cytochrome P-450 CYP2C19
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Drug Therapy, Combination
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Female
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Genotype
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Helicobacter Infections / drug therapy*
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Helicobacter Infections / microbiology
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Helicobacter pylori / drug effects*
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Helicobacter pylori / enzymology
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Helicobacter pylori / genetics
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Helicobacter pylori / isolation & purification
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Humans
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Lansoprazole
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Male
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Middle Aged
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Mixed Function Oxygenases / genetics*
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Polymorphism, Genetic*
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Smoking*
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Treatment Outcome
Substances
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2-Pyridinylmethylsulfinylbenzimidazoles
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Anti-Bacterial Agents
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Anti-Ulcer Agents
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Lansoprazole
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Amoxicillin
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Mixed Function Oxygenases
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Aryl Hydrocarbon Hydroxylases
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CYP2C19 protein, human
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Cytochrome P-450 CYP2C19
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Clarithromycin