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Personalized therapy for Helicobacter pylori: CYP2C19 genotype effect on first-line triple therapy.
Arévalo Galvis, Azucena; Trespalacios Rangel, Alba Alicia; Otero Regino, William.
Afiliação
  • Arévalo Galvis A; Laboratorio de Bacteriología Especial, Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.
  • Trespalacios Rangel AA; Laboratorio de Bacteriología Especial, Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.
  • Otero Regino W; Unidad de Gastroenterología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Helicobacter ; 24(3): e12574, 2019 Jun.
Article em En | MEDLINE | ID: mdl-30859680
BACKGROUND: Triple therapy efficacy against Helicobacter pylori is low worldwide, and thus, alternatives must be sought to improve eradication. The aim of the present study was to determine CYP2C19 genetic polymorphism effect on H pylori eradication. METHODS: A randomized, single-blinded clinical trial including 133 participants was carried out. H pylori infection was confirmed by histologic and microbiologic test. Antibiotic susceptibility to amoxicillin and clarithromycin was performed. CYP2C19 polymorphisms *1, *2, and *3 were analyzed by real-time PCR (Roche ®), and nested PCR for CYP2C19*17 polymorphisms. Participants were randomized into two groups for different H pylori therapies, one with standard omeprazole doses and another with omeprazole doses depending on CYP2C19 polymorphism. H pylori eradication was verified by stool antigen tests (Meridian ®). RESULTS: The most common CYP2C19 polymorphism was *1/*1 in 54.9% of the participants followed by *17/*17 in 21.1%. Triple therapy efficacy with standard omeprazole doses versus personalized therapy based on CYP2C19 polymorphism by ITT analysis was 84% (95% CI: 0.73-0.91) vs 92.2% (95% CI: 0.82-0.97) (P = 0. 14), respectively. The efficacy by PP analysis was 92.1% (95% CI: 0.82-0.97) vs 100% (95% CI: 0.92-0.01) (P = 0.027), respectively. CONCLUSIONS: The most frequent polymorphism was extensive PPI metabolizers (62.4%). Effectiveness of guided therapies by susceptibility test was good, yet they can be further improved by customized therapy based on CYP genotype. Therefore, high PPI (80 mg/d) doses are recommended for H pylori eradication therapies in Colombia. ClinicalTrials.gov ID: NCT03650543.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimorfismo Genético / Helicobacter pylori / Infecções por Helicobacter / Citocromo P-450 CYP2C19 / Antibacterianos Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Helicobacter Assunto da revista: BACTERIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimorfismo Genético / Helicobacter pylori / Infecções por Helicobacter / Citocromo P-450 CYP2C19 / Antibacterianos Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Helicobacter Assunto da revista: BACTERIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido