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CYP2C19 polymorphism influences Helicobacter pylori eradication

World Journal of Gastroenterology 2014年第43期20卷 16029-16036页

作者： Chao-Hung Kuo Chien-Yu Lu Hsiang-Yao Shih Chung-Jung Liu Meng-Chieh Wu Huang-Ming Hu Wen-Hung Hsu Fang-Jung Yu Deng-Chyang Wu Fu-Chen Kuo Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University Hospital Department of Medicine Faculty of MedicineCollege of Medicine and Center for Stem Cell ResearchKaohsiung Medical University Department of Internal Medicine Kaohsiung Municipal Hsiao-Kang Hospital Graduate Institute of Public Health Kaohsiung Medical University School of Medicine College of MedicineE-Da HospitalI-Shou University

The known factors that have contributed to the decline of Helicobacter pylori(***)eradication rate include antibiotic resistance,poor compliance,high gastric acidity,high bacterial load,and cytochrome P450 2C19(CYP2C19)*** pump inhibitor(PPI)is important in the eradication *** principal enzyme implicated in the metabolism of PPIs is *** effects of PPI depend on metabolic enzyme,cytochrome P450 enzymes,and CYP2C19 with genetic differences in the activity of this enzyme(the homozygous EM,heterozygous EM(Het EM),and poor metabolizer).The frequency of the CYP2C19 polymorphism is highly varied among different ethnic *** CYP2C19genotype is a cardinal factor of *** eradication in patients taking omeprazole-based or lansoprazolebased triple *** contrast,the CYP2C19 polymorphism has no significant effect on the rabeprazolebased or esomeprazole-based triple *** efficacy of levofloxacin-based rescue triple therapy might be also affected by the CYP2C19 polymorphism,but CYP2C19 genotypes did not show obvious impact on other levofloxacin-based rescue *** of different PPIs and/or increasing doses of PPIs should be individualized based on the pharmacogenetics background of each patient and pharmacological profile of each *** possible factors influencing gastric acid secretion(e.g.,IL-1β-511 polymorphism)would be also under consideration.

关键词： Helicobacter pylori CYP2C19 Polymorphism eradicati

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Efficacy of moxifloxacin-based sequential and hybrid therapy for first-line Helicobacter pylori eradication

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World Journal of Gastroenterology 2015年第35期21卷 10234-10241页

作者： Jae Jin Hwang Dong Ho Lee Ae-Ra Lee Hyuk Yoon Cheol Min Shin Young Soo Park Nayoung Kim Department of Internal Medicine Seoul National University Bundang Hospital

AIM: To evaluate the efficacy of moxifloxacin-based sequential therapy(MBST) versus hybrid therapy as a first-line treatment for Helicobacter pylori(H. pylori) ***: From August 2014 to January 2015, 284 patients with confirmed H. pylori infection were randomized to receive a 14-d course of MBST(MBST group, n = 140) or hybrid(Hybrid group, n = 144) therapy. The MBST group received 20 mg rabeprazole and 1 g amoxicillin twice daily for 7 d, followed by 20 mg rabeprazole and 500 mg metronidazole twice daily, and 400 mg moxifloxacin once daily for 7 d. The Hybrid group received 20 mg rabeprazole and 1 g amoxicillin twice daily for 14 d. In addition, the Hybrid group received 500 mg metronidazole and 500 mg clarithromycin twice daily for the final 7 d. Successful eradication of H. pylori infection was defined as a negative 13C-urea breath test 4 wk after the end of treatment. Patient compliance was defined as "good" if drug intake was at least 85%. H. pylori eradication rates, patient compliance with treatment, and adverse event rates were ***: The eradication rates in the intention-totreat(ITT) analysis were 91.4%(128/140; 95%CI: 90.2%-92.9%) in the MBST group and 79.2%(114/144; 95%CI: 77.3%-80.7%) in the Hybrid group(P = 0.013). The eradication rates in the perprotocol(PP) analysis were 94.1%(128/136; 95%CI: 92.9%-95.6%) in the MBST group and 82.6%(114/138; 95%CI: 80.6%-84.1%) in the Hybrid group(P = 0.003). The H. pylori eradication rate in the MBST group was significantly higher than that of the Hybrid group for both the ITT(P = 0.013) and the PP analyses(P = 0.003). Both groups exhibited full compliance with treatment(MBST/Hybrid group: 100%/100%). The rate of adverse events was 11.8%(16/136) and 19.6%(27/138) in the MBST and Hybrid group, respectively(P = 0.019). The majority of adverse events were mild-to-moderate in intensity; none were severe enough to cause discontinuation of treatment in either ***: MBST was more effecti

关键词： Helicobacter pylori First-line treatment eradicati

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