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Abstract
Background: Genotypic polymorphisms encoding CYP2C19 affect the
metabolism of proton pump inhibitors (PPIs), thereby affecting the effectiveness of H. pylori treatment eradication. A high - dose dual therapy (HDDT) including PPIs and amoxicillin has been considered for H. pylori eradication with the advantages of ease of use, low side effects and high success rate in the world. The study aimed to investigate the CYP2C19 genotype and its influence on the H. pylori eradication efficiency of this regimen.
Methods: A cross - sectional study on 82 H. pylori infected patients treated with a high - dose dual regimen consisting of esomeprazole and amoxicillin for 14 days and evaluated the results of H. pylori eradication treatment in general and by CYP2C19 metabolizing groups.
Results: A total of 82 patients (39 males, 43 females), mean age 38.26 ± 12.25. The main symptom of the patient was epigastric pain, in which, 81.7% of patients had gastritis, 9.8% of gastric ulcer and 8.5% of duodenal ulcer on endoscopy. The genotype distribution of CYP2C19 with extensive - (EM), intermediate - (IM), poor - (PM) metaboliser were 41.5%, 47.5%, 11%, respectively. Successful H. pylori eradication of HDDT with the intention - to - treat (ITT) was 76.8%, and 81.8% according to the perprotocol (PP). The successful eradication rates in the group with poor - intermediate -
and extensive - metaboliser of CYP2C19 were 88.9%, 86.5% and 74.2%, respectively (p > 0.05). Patients with side effects during treatment accounted for 22.1% with mostly mild severity, mainly nausea (9.1%), fatigue (9.1%), diarrhea (2.6%).
Conclusions: The effectiveness of H. pylori eradication of the high - dose dual regimen was quite good when analyzed according to the per - protocol. It is an alternative choice in some cases with the advantages of low side effects and simple use. Although the eradication success rate in patients with poor metaboliser of CYP2C19 tends to be higher than that in intermediate - and extensive - metabolisers, the difference was not statistically significant, requiring more studies with larger sample in the future.
Keywords: H. pylori, CYP2C19, PPIs & amoxicillin, HDDT
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| Published | 11-01-2025 | |
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| Issue | No. 85 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.85.16 | |
| Keywords | Từ khóa: H. pylori, CYP2C19, PPIs và amoxicillin, HDDT. Keywords: H. pylori, CYP2C19, PPIs & amoxicillin, HDDT. |
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