Effect of Rabeprazole on Eradication of Helicobacter Pylori and Its Correlation to CYP2C19 Genetic Polymorphisms

Objective:To investigate the efficacy of 1-week triple therapy with amoxicillin, clarithromycin and either rabeprazole or omeprazole in the eradication of Helicobacter pylori(H. pylori) and to investigate whether or not the CYP2C19 genotype affected the eradication rate. Methods: One hundred and sixty-nine patients with chronic H. pylori positive gastritis confirmed by endoscopy and histology were eligible to this study. Patients were randomly assigned to receive one of the two regimens:clarithmycin 500mg bid and amoxicillin 1000 mg bid together with either rabeprazole 10 mg bid or omeprazole 20 mg bid for 1 week course. Their blood CYP2C19 genotyping was detected by PCR-RFLP. Results: One hundred and sixty patients completed the trial.The difference of the eradication rates of H. pylori in RAC group and OAC group did not reach significant on a per protocol analysis and on an intention-to-treat analysis(P0.05). In RAC group, CYP2C19 genetic polymorphism did not show significant effect on the efficacy in this groups. In OAC group, there were statistically significant differences between EM and IM(P0.01) or PM(P0.05), but not between PM and IM(P0.05). Conclusion: Both RAC and OAC triple therapy eradicated H. pylori effectively. The efficacy of rabeprazole-based triple therapy was less affected by the CYP2C19 genotype.