Effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitor-based triple therapy for Helicobacter pylori eradication: a meta-analysis.

摘要: Objective: CYP2C19 polymorphisms have been inconsistently reported to associate with the efficacy of proton pump inhibitor (PPI)-based triple therapies for eradicating Helicobacter pylori infection. The aim this meta-analysis was determine whether polymorphism affect H. pylori eradication rates obtained first-line PPI-based therapies. Methods: A systematic literature search conducted up July 2007 using Medline, PubMed, EMBase, Cochrane Central Register Controlled Trials (CENTRAL), ISI Web Science, CNKI (Chinese), and Wanfang (Chinese) digital database. MeSH terms keywords included inhibitor, omeprazole, lansoprazole, rabeprazole, pantoprazole, or esomeprazole, cytochromeP4502C19 CYP2C19, Helicobacter pylori H. pylori. Twenty articles met inclusion criteria, were in by Review Manager 4.2.8. Results: Eradication significantly different between poor metabolizers (PM) heterozygous extensive (HetEM) (odds ratio (OR) = 1.73, p = .002) PM homozygous (HomEM) (OR = 2.79, p < .0001). Moreover, also significant difference HetEM HomEM (OR = 2.00, Triple omeprazole lansoprazole achieved higher than (OR = 4.28, p = .0005 OR = 3.06, p = .001 lansoprazole), those (OR = 3.22, p < .0001 OR = 1.95, p = .040 lansoprazole). Rabeprazole had no effect on (between HomEM, OR = 1.35, p = .610 OR = 1.57, p = .190). No observed three individual PPI therapies. Conclusion: omeprazole- lansoprazole-based at standard doses is dependent genotype status, which appears not regimens including rabeprazole.