Efficacy of rabeprazole (Razo®) in the treatment of various clinical variants of GERD: results from the GERBERA study

The influence of CYP2C19 polymorphism on the effectiveness of the treatment of acid-dependent diseases

Introduction. In modern systematic reviews, there is a point of view that CYP2C19 polymorphism affects the results of treatment of peptic ulcer, erosive esophagitis and eradication of Helicobacter pylori.

Оbjective. To evaluate the effect of CYP2C19 polymorphism on the effectiveness of treatment with rabeprazole at a dose of 20 mg once a day in patients with GERD during 2 and 4 weeks of treatment.

Materials and methods. In total, the study included 75 patients with GERD (36 men and 39 women, mean age 41.7 ± 1.5 years). A clinical examination with the completion of standard questionnaires took place during three visits: before the start of treatment, after 2 and after 4 weeks of therapy. Esophagogastroduodenoscopy was performed in all patients before treatment and in patients with esophagitis after 4 weeks of therapy. All patients received rabeprazole at a dose of 20 mg once a day. Genotyping of single nucleotide polymorphisms of CYP2C19 metabolizer genes was carried out by real-time polymerase chain reaction. Ultrarapid, rapid, normal, intermediate and poor CYP2C19 metabolizers have been isolated.

Results. Of the 75 patients examined, 8.0% of patients were ultrarapid metabolizers, 30.7% of people were rapid, 49.3% of individuals were normal, 10.7% of persons were intermediate, and 1.3% of patients were poor CYP2C19 metabolizers. Response after 4 weeks of treatment with rabeprazole 20 mg once daily was 94.4% for NERD and 90.5% for erosive esophagitis. In ultrarapid and rapid metabolizers of CYP2C19, a complete response to rabeprazole therapy was registered in 81.3% of NERD patients and in 84.6% of patients with erosive esophagitis.

Conclusion. Based on the results of the study, we obtained high efficacy of Razo® at a dose of 20 mg 1 time per day for the treatment of GERD in a group of patients with a predominance of rapid and normal metabolizers of CYP2C19.