The effect of cytochrome P2C19 and interleukin-1 polymorphisms on H. pylori eradication rate of 1-week triple therapy with omeprazole or rabeprazole, amoxycillin and clarithromycin in Chinese people

What is known and objective: Genetic polymorphism of interleukin (IL)–1β and IL‐1 receptor antagonist (IL‐1rα) are associated with efficacy of acid suppression, whereas cytochrome P (CYP) 2C19 polymorphism influences the metabolism of proton pump inhibitor family. Thus, CYP2C19 and IL‐1 polymorphisms may affect the efficacy of H. pylori eradication therapy. We compared the efficacies of omeprazole and rabeprazole on eradication of H. pylori in relation to CYP2C19, IL‐1B and IL‐1RN genotypes in Chinese people. Methods: Two hundred and forty Chinese with peptic ulcer disease were randomly assigned to the following regimens: amoxicillin and clarithromycin together with omeprazole (OAC) or rabeprazole (RAC). CYP2C19*2 and *3, IL1B‐511, IL1B‐31, IL1B+ 3954 and intron 2 of the IL‐1RN genotypes were analyzed by polymerase chain reaction‐restriction fragment length polymorphism. Results: The intention‐to‐treat‐based cure rate of the OAC regimen was significantly lower than that of the RAC regimen in the CYP2C19 wild‐type homozygotes (P = 0·014). No significant differences in the cure rates were observed among the IL‐1RN and the IL‐1B genotype groups. What is new and conclusions: The rabeprazole‐based triple regimen was better than the omeprazole in Chinese patients with the CYP2C19 extensive metabolizer genotype. The effectiveness of the PPI/AC regimen is unrelated to IL‐1B and IL1‐RN genetic polymorphism.