title: Prevention of gastric mucosal injury induced by anti-platelet drugs by famotidine.
abstract: Anti-platelet drug-induced gastric mucosal injury correlates with intragastric pH. Our aim was to investigate prophylaxis effects of famotidine, one of the representative histamine-2 receptor antagonists (H2RA), on gastric mucosal injury induced by dual therapy with low-dose aspirin and clopidogrel in relation to Helicobacter pylori (H. pylori) infection and CYP2C19 genotypes. This study was conducted for 20 healthy Japanese volunteers (10 H. pylori-positive and 10-negative subjects) with 100 mg aspirin plus 75 mg clopidogrel (AC) once-daily dosing and AC plus 20 mg famotidine twice-daily dosing (ACH). Mucosal injury was endoscopically assessed on day 3 and 7 and 24-hour intragastric pH and antiplatelet-function test was performed on day 7. Median pH in ACH was similar between CYP2C19 extensive metabolizer (EM) and intermediate metabolizer (IM)/poor metabolizer (PM) and was significantly higher in H. pylori-positive than negative subjects (P < .05). Mucosal injury with ACH significantly decreased in both day 3 and 7 compared with AC, irrespective with H. pylori and CYP2C19 genotypes (P < .05). Although antiplatelet effect of clopidogrel in EM was significantly higher than that in IM/PM, the additional famotidine did not affect the effect. Anti-platelet drug-induced gastric injury was alleviated by famotidine without attenuation of anti-platelet functions irrespective of H. pylori and CYP2C19 genotypes.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uotani
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nishino
authors.forename: Hitomi
authors.initials: H
authors.lastname: Ichikawa
authors.forename: Shu
authors.initials: S
authors.lastname: Sahara
authors.forename: Mihoko
authors.initials: M
authors.lastname: Yamade
authors.forename: Moriya
authors.initials: M
authors.lastname: Iwaizumi
authors.forename: Takanori
authors.initials: T
authors.lastname: Yamada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Osawa
authors.forename: Ken
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Umemura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyajima
authors.forename: Takahisa
authors.initials: T
authors.lastname: Furuta
mesh_terms: D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D044466:Asian People / Q000235:genetics; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics; D004359:Drug Therapy, Combination; D015738:Famotidine / Q000008:administration & dosage*; D005260:Female; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D005838:Genotype; D016481:Helicobacter Infections / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000008:administration & dosage*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D055815:Young Adult
chemical_list: D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D010975:Platelet Aggregation Inhibitors; D015738:Famotidine; D000077144:Clopidogrel; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine; D001241:Aspirin
keywords: H. pylori; clopidogrel; famotidine; low-dose aspirin; rabeprazole