Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing.
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CYP2C19和质子泵抑制剂给药的临床药物遗传学实施联盟(CPIC)指南。

DOI:
10.1002/cpt.2015
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发表时间:
2021-06
影响因子:
6.7
通讯作者:
Furuta T
Furuta T
中科院分区:
医学2区
文献类型:
--
作者:
Lima JJ;Thomas CD;Barbarino J;Desta Z;Van Driest SL;El Rouby N;Johnson JA;Cavallari LH;Shakhnovich V;Thacker DL;Scott SA;Schwab M;Uppugunduri CRS;Formea CM;Franciosi JP;Sangkuhl K;Gaedigk A;Klein TE;Gammal RS;Furuta T

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质子泵抑制剂(PPI)被广泛用于治疗和预防许多疾病,包括胃食道反流病、胃和十二指肠溃疡、腐蚀性食管炎、幽门螺杆菌感染和病理性高分泌条件。大多数PPI主要由CYP2C19代谢成非活性代谢物,而CYP2C19基因与PPI的暴露、疗效和不良反应有关。我们总结了文献中的证据,并为基于CYP2C19基因的PPI处方提供了治疗建议(更新请访问www.cpicpgx.org)。使用CYP2C19基因数据来指导PPI治疗的潜在好处包括:1)识别出预测较低血浆暴露的基因类型的患者,并给他们开出更高剂量的处方,以增加疗效的可能性;2)确定预测较高血浆暴露的慢性治疗患者,给他们开较少的剂量,以最大限度地减少与长期使用PPI有关的毒性风险,特别是在较高的血浆浓度下。
Proton pump inhibitors (PPIs) are widely used for acid suppression in the treatment and prevention of many conditions including gastroesophageal reflux disease, gastric and duodenal ulcers, erosive esophagitis, H. pylori infection, and pathological hypersecretory conditions. Most PPIs are metabolized primarily by CYP2C19 into inactive metabolites, and CYP2C19 genotype has been linked to PPI exposure, efficacy, and adverse effects. We summarize the evidence from the literature and provide therapeutic recommendations for PPI prescribing based on CYP2C19 genotype (updates at www.cpicpgx.org). The potential benefits of using CYP2C19 genotype data to guide PPI therapy include 1) identifying patients with genotypes predictive of lower plasma exposure and prescribing them a higher dose that will increase the likelihood of efficacy; and 2) identifying patients on chronic therapy with genotypes predictive of higher plasma exposure and prescribing them a decreased dose to minimize the risk of toxicity that is associated with long-term PPI use, particularly at higher plasma concentrations.
DOI: 10.1002/jcph.977
发表时间: 2018-01-01
影响因子: 2.9
作者:
Franciosi, James P.;Mougey, Edward B.;Lima, John J.
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