Update on the Pharmacogenomics of Proton Pump Inhibitors
Update on the Pharmacogenomics of Proton Pump Inhibitors Krisztina Hagymási; Katalin Müllner; László Herszényi; Zsolt Tulassay
Pharmacogenomics. 2011;12(6):873-888.
Pharmacogenetic Aspects of the Clinical Practice with PPIs
A significant proportion (~10–20%) of patients treated with PPIs are nonresponders to the treatment.[30,31] Inappropriate antisecretory action was described.[32] Failed eradication therapies can presumably be explained, not only by resistance to antibiotics, but also by inadequate inhibition of gastric acid secretion. Diverse individual pharmacogenetic properties also play a crucial role in the failed therapeutic attempts. In clinical practice, the most relevant pharmacogenetic factor was demonstrated to be the CYP2C19 rapid metabolizer genotype. The rate of CYP2C19 rapid metabolizers was proven to be higher in Europe and in North America (56–81%), while the proportion was smaller (27–38%) in the Asian population.[31,33]
A large segment of the CYP2C19 rapid metabolizer subgroup is nonresponder to the PPI treatment, only partial symptom relief in GERD, more frequent unsuccessful eradication therapy and lower healing rates of gastroduodenal ulcers were observed.[6]
