The effects of lansoprazole on erosive reflux oesophagitis are influenced by CYP2C19 polymorphism.
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.
Kawamura
M
M
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. dq8m-kwmr@asahi-net.or.jp
Ohara
S
S
Koike
T
T
Iijima
K
K
Suzuki
J
J
Kayaba
S
S
Noguchi
K
K
Hamada
S
S
Noguchi
M
M
Shimosegawa
T
T
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
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; D003577:Cytochrome P-450 Enzyme System; D009853:Omeprazole