A comparative study on endoscopic ulcer healing of omeprazole versus rabeprazole with respect to CYP2C19 genotypic differences
| Autor: | Hirokazu Kajikawa, Takashi Ishizaki, Yasuyuki Nagao, Haruki Kato, Nobuyuki Seto, Norimasa Yoshida, Toshikazu Yoshikawa, Makoto Shimozawa, Yutaka Isozaki, Takashi Ando, Yuji Naito, Naohito Sugimoto, Hitoshi Hongo |
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| Rok vydání: | 2004 |
| Předmět: |
Ulcer healing
Adult Male medicine.medical_specialty Genotype Physiology medicine.drug_class Rabeprazole Proton-pump inhibitor CYP2C19 Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Endoscopy Gastrointestinal Mixed Function Oxygenases Double-Blind Method Internal medicine Medicine Humans Stomach Ulcer Omeprazole Polymorphism Genetic business.industry Hepatology Middle Aged Anti-Ulcer Agents digestive system diseases Treatment period Cytochrome P-450 CYP2C19 Treatment Outcome Benzimidazoles Female Aryl Hydrocarbon Hydroxylases business medicine.drug |
| Zdroj: | Digestive diseases and sciences. 50(9) |
| ISSN: | 0163-2116 |
| Popis: | Omeprazole is mainly metabolized in the liver by CYP2C19, a genetically determined enzyme, while rabeprazole is mainly nonenzymatically degraded with a minor involvement by CYP2C19. We investigated the gastric ulcer healing effect of omeprazole versus rabeprazole evaluated endoscopically with reference to the different CYP2C19 genotypes. Eighty patients with active gastric ulcer were treated with a daily dose of 20 mg of omeprazole or 10 mg of rabeprazole. The endoscopic evaluation was performed at the baseline and 2- and 8-week posttreatment periods. The endoscopic improvement of gastric ulcer size and ulcer healing rates using a thin rubber disc with a diameter of 6 mm, were evaluated in relation to the CYP2C19 genotypic status. The mean 2-week posttreatment ulcer size value by rabeprazole did not significantly differ among the different CYP2C19 genotypes, whereas the mean value in the homozygous extensive metabolizer patients treated with omeprazole was significantly (P = 0.0057) greater than in those with rabeprazole. However, after the 8-week treatment, omeprazole and rabeprazole showed the similarly high healing rates of 87.8% (31/37) and 88.9% (32/36), respectively. Although both omeprazole and rabeprazole showed a high healing rate of gastric ulcer after the 8-week treatment period, the healing effect of rabeprazole appears to be relatively independent of the CYP2C19 status, resulting in an earlier repair of gastric mucosal damage evaluated endoscopically compared to that of omeprazole. |
| Databáze: | OpenAIRE |
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