2006 Fiscal Year Final Research Report Summary
Pharmacogenomics-based tailored strategy for eradication of H. pylori
| Project/Area Number |
17590470
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Applied pharmacology
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| Research Institution | Hamamatsu University School of Medicine |
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Principal Investigator |
FURUTA Takahisa Hamamatsu University School of Medicine, Center for Clinical Research, 医学部附属病院, 准教授 (10303546)
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| Co-Investigator(Kenkyū-buntansha) |
SHIRAI Naohito Hamamatsu University School of Medicine, Department of Laboratory Meicine, 医学部, 助手 (90362194)
SUGIMOTO Mistustuge Hamamatsu University School of Medicine, First Department of Medicine, 医学部, 助教授 (80397398)
NAKAMURA Akiko Hamamatsu University School of Medicine, First Department of Medicine, 医学附属病院, 医員 (80397413)
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| Project Period (FY) |
2005 – 2006
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| Keywords | CYP2C19 / Helicobacter pylori / 23S rRNA / tailored Medicine / lansoprazole / clarithromycin / amoxicillin / eradication |
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| Research Abstract |
Background : H. pylori eradication rates by triple therapy with a proton pump inhibitor, amoxicillin and clarithromycin at standard doses depend on bacterial susceptibility to clarithromycin and patient CYP2C19 genotypes. We examined the usefulness of a personalized therapy for H. pylori infection based on these factors as determined by genetic testing.
Methods : First, optimal lansoprazole dosing schedules that would achieve sufficient acid inhibition to allow H. pylori eradication therapy in each of different CYP2C19 genotype groups were determined by a 24-hour intragastric pH monitoring. Next, 300 H. pylori-positive patients were randomly assigned to the standard regimen group (lansoprazole 30 mg bid, clarithromycin 400 mg bid, and amoxicillin 750 mg bid for one week) or the tailored regimen group based on CYP2C19 status and bacterial susceptibility to clarithromycin assessed by genetic testing. Patients with failure of eradication underwent the second-line regimen. The per-patient cost required for successful eradication was calculated for each of the groups.
Results : In the first-line therapy, the intention-to-treat eradication rate in the tailored regimen group was 96.0% (95%CI=91.5%-98.2%, 144/150), significantly higher than that in the standard regimen group (70.0% : 95%CI = 62.2%-77.2%, 105/150) (P < 0.001). Final costs per successful eradication in the tailored and standard regimen groups were $ 377.1 and $ 376.9, respectively.
Conclusions : The pharmacogenomics-based tailored treatment for H. pylori infection allowed a higher eradication rate by the initial treatment without an increase of the final per-patient cost for successful eradication. However, the precise cost-effectiveness of this strategy remains to be determined.
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Research Products
(52 results)
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[Journal Article] Pharmacogenomics-based tailored versus standard therapeutic regimen for eradication of H. pylori2007
Author(s)
Furuta T, Shirai N, Kodaira M, Sugimoto M, Nogaki A, Kuriyama S, Iwaizumi M, Yamade M, Terakawa I, Ohashi K, Ishizaki T, Hishida A
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Journal Title
Clin Pharmacol Ther 22
Pages: 521-528
Description
「研究成果報告書概要(和文)」より
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[Journal Article] THE ACID-RELATED SYMPTOM (ARS) RESEARCH GROUP. Efficacy of rabeprazole on heartburn symptom resolution in patients with non-erosive and erosive gastro-oesophageal reflux disease : a multicenter study from Japan.2007
Author(s)
Miwa H, Sasaki M, Furuta T, Koike T, Habu Y, Ito M, Fujiwara Y, Wada T, Nagahara A, Hongo M, Chiba T, Kinoshita Y
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Journal Title
Aliment Pharmacol Ther 26
Pages: 69-77
Description
「研究成果報告書概要(和文)」より
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[Journal Article] Pharmacogenomics-based tailored versus standard therapeuti regimen for eradication of H. pylori.2007
Author(s)
Furuta T, Shirai N, Kodaira M, Sugimoto M, Nogaki Kuriyama S, Iwaizumi M, Yamade M, Terakawa I, Ohashi K, Ishizaki T, Hishida A.
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Journal Title
Clin Pharmacol Ther 81
Pages: 521-8
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] THE ACID-RELATED SYMPTOM (ARS) RESEARCH GROUP. Efficacy of rabeprazole on heartburn symptom resolution in patients with non-erosive and erosive gastro-oesophageal reflux disease : a multicenter study from Japan.2007
Author(s)
Miwa H, Sasaki M, Furuta T, Koike T, Habu Y, Ito M, Fujiwara Y, Wada T, Nagahara A, Hongo M, Chiba T, Kinoshita Y.
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Journal Title
Aliment Pharmacol Ther 26
Pages: 69-77
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] Helicobacter pylori eradication and metachronous gastric cancer after endoscopic mucosal resection of early gastric cancer.2006
Author(s)
Nakagawa S, Asaka M, Kato M, Nakamura T, Kato C, Fujioka T, Tatsuta M, Keida K, Terao S, Takahashi S, Uemura N, Kato T, Aoyama N, Saito D, Suzuki M, Imamura A, Sato K, Miwa H, Nomura H, Kaise M, Oohara S, Kawai T, Urabe K, Sakaki N, Ito S, Noda Y, Yanaka A, Kusugami K, Goto H, Furuta T, Fujino M, Kinjyou F, Ookusa T
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Journal Title
Aliment Pharmacol Ther. 2006 Suppl 4
Pages: 214-218
Description
「研究成果報告書概要(和文)」より
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[Journal Article] Helicobacter pylori eradication and metachronous gastric cancer after endoscopic mucosal resection of earl gastric cancer.2006
Author(s)
Nakagawa S, Asaka M, Kato M, Nakamura T, Kato C, Fujioka T, Tatsuta M, Keida K, Terao S, Takahashi S, Uemura N, Kato T, Aoyama N, Saito D, Suzuki M, Imamura A, Sato K, Miwa H, Nomura H, Kaise M, Oohara S, Kawai T, Urabe K, Sakaki N, Ito S, Noda Y, Yanaka A, Kusugami K, Goto H, Furuta T, Fujino M, Kinjyou F, Ookusa T.
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Journal Title
Aliment Pharmacol Ther Suppl 4
Pages: 214-8
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] Influence of CYP 2C19 polymorphism and H. pylori genotype determined from gastric tissue samples on response to triple therapy for H. pylori infection.2005
Author(s)
Furuta T, Sagehashi Y, Shirai N, Sugimoto M, Nakamura A, Kodaira M, Kenmotsu K, Nagano M, Egashira T, Ueda K, Yoneyama M, Ohashi K, Ishizaki T, Hishida A.
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Journal Title
Clin Gastroenterol Hepatol 3
Pages: 564-73
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] Modified allele specific primer-PCR method for analyses of susceptibility of H. pylori strains to clarithromycin
Author(s)
Furuta T, Soya Y, Sugimoto M, Shirai N, Nakamura A, Kodaira, Nishino M, Okuda M, Okimoto T, Murakami K, Fujioka T, Akira Hishida A
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Journal Title
J Gastroenterol Hepatol (In press)
Description
「研究成果報告書概要(和文)」より
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[Journal Article] Serum pepsinogens as an early diagnostic marker of H. pylori eradication.
Author(s)
Shirai N, Furuta T, Sugimoto M, Watanabe F, Takashima M, Yamada M, Futami H, Sato Y, Kubota H, Kodaira M, Kajimura M, Masato M, Hishida A
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Journal Title
Hepatogastroenterology (In press)
Description
「研究成果報告書概要(和文)」より
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[Journal Article] Dual therapy with high doses of rabeprazole and amoxicillin versus triple therapy with rabeprazole, amoxicillin and metronidazole as the rescue regimen for Helicobacter pylori infection after triple therapy.
Author(s)
Shirai N, Sugimoto M, Kodaira C, Nishino M, Ikuma M, Kajimura M, Ohashi K, Ishizaki T, Hishida A, Furuta T
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Journal Title
Eur J Clin Pharmacol (In press)
Description
「研究成果報告書概要(和文)」より
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[Journal Article] Modified allele specific primer-PCR method for analyses of susceptibility of H. pylori strains to clarithromycin.
Author(s)
Furuta T, Soya Y, Sugimoto M, Shirai N, Nakamura A, Kodaira, Nishino M, Okuda M, Okimoto T, Murakami K, Fujioka T, Akira Hishida A.
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Journal Title
J Gastroenterol Hepatol (in press)
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] Serum pepsinogens as an early diagnostic marker of H. pylori eradication.
Author(s)
Shirai N, Furuta T, Sugimoto M, Watanabe F, Takashima M, Yamada M, Futami H, Sato Y, Kubota H, Kodaira M, Kajimura M, Masato M, Hishida A.
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Journal Title
Hepatogastroenterology (in press)
Description
「研究成果報告書概要(欧文)」より
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[Journal Article] Dual therapy with high doses of rabeprazole and amoxicillin versus triple therapy with rabeprazole, amoxicillin and metronidazole as the rescue regimen for Helicobacter pylori infection after triple therapy
Author(s)
Shirai N, Sugimoto M, Kodaira C, Nishino M, Ikuma M, Kajimura M, Ohashi K, Ishizaki T, Hishida A, Furuta T.
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Journal Title
Eur J Clin Pharmacol (in press)
Description
「研究成果報告書概要(欧文)」より
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