Abstract：
INTRODUCTION:The aim of therapeutic regimens using proton pump inhibitors (PPIs) in patients with acid-related diseases is to potently inhibit acid secretion for the full 24 h. However, optimum treatment is still unclear because the pharmacodynamics of PPIs differ among CYP2C19 genotypes and most of the previous studies have had loss of sample power. METHODS:Using pH monitoring, we compared acid inhibition at standard dosage of omeprazole (20 mg, 50 times), lansoprazole (30 mg, 68 times), and rabeprazole (10 mg, 65 times) in Helicobacter pylori-negative healthy young Japanese volunteers. RESULTS:Median pH with rabeprazole was 5.4 (3.3-7.5), which was significantly greater than with either omeprazole [4.4 (2.1-7.3)] or lansoprazole [4.8 (3.5-6.4)] (both P < 0.05). Median 24-h pH differed among the different CYP2C19 genotypes in all three PPIs. In CYP2C19 extensive metabolizers (EMs), the genotype that is refractory to PPI treatment, median pH with omeprazole, lansoprazole, and rabeprazole was 3.8 (2.1-4.4), 4.5 (3.5-5.3) and 4.8 (3.3-7.5), respectively. DISCUSSION:Treatment with the selected PPIs at their standard dosages had difficulty maintaining acid inhibition for a full 24 h, especially in CYP2C19 EM. However, rabeprazole has the merit of less influence of CYP2C19 genotype compared with the other PPIs.
journal_name
Eur J Clin Pharmacoljournal_title
European journal of clinical pharmacologyauthors
Sugimoto M,Shirai N,Nishino M,Kodaira C,Uotani T,Sahara S,Ichikawa H,Kagami T,Sugimoto K,Furuta Tdoi
10.1007/s00228-014-1713-ysubject
Has Abstractpub_date
2014-09-01 00:00:00pages
1073-8issue
9eissn
0031-6970issn
1432-1041journal_volume
70pub_type
临床试验,杂志文章abstract：PURPOSE:The use of estimated glomerular filtration rate (eGFR) in daily clinical practice. METHODS:eGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a serum creatinine testing is ordered. In this paper, we will discuss how to...
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journal_title：European journal of clinical pharmacology
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