The efficacy of proton pump inhibitor (PPI) medications is highly dependent on plasma concentrations, which varies considerably due to cytochrome P450 (CYP2C19) genetic variation. We conducted a pragmatic, pilot study of CYP2C19 genotype-guided pediatric dosing of PPI medications. Children aged 5-17 years old with gastric-acid-related conditions were randomized to receive either conventional dosing of a PPI or genotype-guided dosing for a total of 12 weeks. Sixty children (30 in each arm) were enrolled and had comparable baseline characteristics. The mean daily omeprazole equivalent dose prescribed to participants across metabolizer phenotype groups was significantly different in the genotype-guided dosing arm (P < 0.001), but not in the conventional dosing arm. Prescribers waited for the genotype result before prescribing the PPI medication for 90% of the participants in the genotype-guided dosing arm. The number of participants who reported an infection was marginally lower in genotype-guided dosing vs. conventional dosing (20% vs. 44%; P = 0.07). Sinonasal symptoms were higher in the conventional dosing arm as compared with genotype-guided dosing arm: (2.6 (2.0, 3.4) vs. 1.8 (1.0, 2.3), P = 0.031). CYP2C19 genotype-guided PPI therapy is feasible in a clinical pediatric setting, well accepted by providers, resulted in differential PPI dosing, and may reduce PPI-associated infections. A future large scale randomized clinical trial of CYP2C19 genotype-guided pediatric dosing of PPI medications in children is warranted.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440564 | PMC |
| http://dx.doi.org/10.1111/cts.12589 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Conservative management of emphysematous esophagitis-a case report.
Mediastinum
July 2024
Department of Radiology, Inje University Sanggye Paik Hospital, Seoul, Korea.
Background: Emphysematous esophagitis is a very rare disease and there are only a few previous reports in the literature. Previously reported cases have resulted in emphysematous esophagitis following anterior cervical procedures or ingestion of hydrogen peroxide (HP). In this report, we describe a case in which a patient with emphysematous esophagitis accompanied by gastritis without the above predisposing factors was treated with conservative treatment.
View Article and Find Full Text PDFAn Outline on benzimidazole Containing Marketed Drugs with Proton Pump Inhibitor and H Receptor Antagonist Activities.
Mini Rev Med Chem
January 2025
Department of Chemistry, Kurukshetra University, Kurukshetra, Kurukshetra, 136119, India.
Heterocyclic compounds are increasingly used in medicinal chemistry because they are the main components of many biological processes and materials. Benzimidazole remains the core center of the heterocyclic chemical group, with essential traits such as six-five-member connected rings and two nitrogen atoms at the 1,3 position in a six-membered benzene and five-membered imidazole- fused ring system. Molecules with benzimidazole derivatives serve important functions as therapeutic agents and have shown excellent results in clinical and biological research.
View Article and Find Full Text PDFTrial of alginates in throat symptoms: protocol for a pragmatic, multicentre, placebo controlled, double blind, parallel, randomised controlled trial of liquid alginate (Gaviscon Advance) for the treatment of persistent throat symptoms.
BMJ Open
January 2025
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
Introduction: Persistent throat symptoms (PTS) are indicators for over 60 000 new patient referrals to NHS secondary care annually. PTS have been attributed to manifestation of gastro-oesophageal reflux disease (GORD) with the hypothesis that gastric refluxate damages and irritates the mucosa of the upper aerodigestive tract. Symptoms of PTS and GORD are commonly treated with proton pump inhibitors (PPIs) or alginates are often, incorrectly, advocated.
View Article and Find Full Text PDFCOA5 has an essential role in the early stage of mitochondrial complex IV assembly.
Life Sci Alliance
March 2025
https://ror.org/01kj2bm70 Mitochondrial Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
Pathogenic variants in cytochrome oxidase assembly factor 5 (COA5), a proposed complex IV (CIV) assembly factor, have been shown to cause clinical mitochondrial disease with two siblings affected by neonatal hypertrophic cardiomyopathy manifesting a rare, homozygous missense variant (NM_001008215.3: c.157G>C, p.
View Article and Find Full Text PDFPredictors for the Development of Hypergastrinemia in Maintenance Treatment for Mild Gastroesophageal Reflux Disease Using a Half-dose Proton Pump Inhibitor.
J Neurogastroenterol Motil
January 2025
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
Background/aims: Serum gastrin levels may be elevated following proton pump inhibitor (PPI) therapy. We aim to elucidate the predictors for the development of hypergastrinemia in maintenance treatment for mild gastroesophageal reflux disease (GERD) using a half-dose PPI.
Methods: This study analyzed data from a prospective randomized trial to compare continuous versus on-demand maintenance treatment modalities in patients with mild GERD.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!