title: The effects of lansoprazole on erosive reflux oesophagitis are influenced by CYP2C19 polymorphism.
abstract: BACKGROUND
  The acid suppressive effect of lansoprazole is influenced by the P450 2C19 (CYP2C19) polymorphism.
  
  
  OBJECTIVE
  To investigate whether the CYP2C19 genotype is related to the healing of erosive reflux oesophagitis during treatment with lansoprazole.
  
  
  METHODS
  Eighty-eight Japanese patients with erosive reflux oesophagitis were treated with a daily oral dose of 30 mg lansoprazole for 8 weeks. The CYP2C19 genotype, Helicobacter pylori infection status and serum pepsinogen I/II ratio were assessed before treatment. At 4 and 8 weeks, the healing of erosive reflux oesophagitis was evaluated endoscopically.
  
  
  RESULTS
  The healing rates were 57.1%, 69.2% and 72.7% at 4 weeks and 77.4%, 95.0% and 100% at 8 weeks in homozygous extensive metabolizers, heterozygous extensive metabolizers and poor metabolizers, respectively. At 8 weeks, the healing rate of erosive reflux oesophagitis was significantly lower in homozygous extensive metabolizers than in the other two groups (P < 0.05). The H. pylori status and serum pepsinogen I/II ratio had less influence than CYP2C19 polymorphism on the healing rate of erosive reflux oesophagitis.
  
  
  CONCLUSIONS
  The therapeutic effect of lansoprazole on erosive reflux oesophagitis is influenced by the CYP2C19 genotype status. Therefore, a test of CYP2C19 genotype may be useful for the medical treatment of reflux oesophagitis with lansoprazole.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. dq8m-kwmr@asahi-net.or.jp
authors.forename: M
authors.initials: M
authors.lastname: Kawamura
authors.forename: S
authors.initials: S
authors.lastname: Ohara
authors.forename: T
authors.initials: T
authors.lastname: Koike
authors.forename: K
authors.initials: K
authors.lastname: Iijima
authors.forename: J
authors.initials: J
authors.lastname: Suzuki
authors.forename: S
authors.initials: S
authors.lastname: Kayaba
authors.forename: K
authors.initials: K
authors.lastname: Noguchi
authors.forename: S
authors.initials: S
authors.lastname: Hamada
authors.forename: M
authors.initials: M
authors.lastname: Noguchi
authors.forename: T
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D003577:Cytochrome P-450 Enzyme System; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use*; D011110:Polymorphism, Genetic; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; D003577:Cytochrome P-450 Enzyme System; D009853:Omeprazole