A Pharmacogenetics-Based Approach to Managing Gastroesophageal Reflux Disease: Current Perspectives and Future Steps.

IF 1.8 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Eda Eken, David S Estores, Emily J Cicali, Kristin K Wiisanen, Julie A Johnson
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引用次数: 1

Abstract

Proton pump inhibitors (PPIs) are commonly used medications to treat acid-related conditions, including gastro-esophageal reflux disease (GERD). Gastroenterology guidelines mention the importance of CYP2C19 in PPI metabolism and the influence of CYP2C19 genetic variations on variable responses to PPIs, but do not currently recommend the genotyping of CYP2C19 prior to prescribing PPIs. There are strong data to support the influence of CYP2C19 genetic variations on the pharmacokinetics of PPIs and clinical outcomes. Existing pharmacogenetic guideline recommendations for dose increases focus on H. pylori and erosive esophagitis indications, but PPIs are also the main therapy for treating GERD. Recent data suggest GERD patients being treated with a PPI may also benefit from genotype-guided dosing. We summarize the literature supporting this contention and highlight future directions for improved management of patients with GERD through precision medicine approaches.

Abstract Image

Abstract Image

基于药物遗传学的治疗胃食管反流病的方法:目前的观点和未来的步骤。
质子泵抑制剂(PPIs)是治疗酸相关疾病的常用药物,包括胃食管反流病(GERD)。胃肠病学指南提到了CYP2C19在PPI代谢中的重要性,以及CYP2C19基因变异对PPI可变反应的影响,但目前不建议在开PPI处方前进行CYP2C19基因分型。有强有力的数据支持CYP2C19基因变异对PPIs药代动力学和临床结果的影响。现有的药理学指南建议增加剂量的重点是幽门螺杆菌和糜烂性食管炎适应症,但PPIs也是治疗胃食管反流的主要治疗方法。最近的数据表明,接受PPI治疗的胃食管反流患者也可能受益于基因型引导给药。我们总结了支持这一论点的文献,并强调了通过精确医学方法改善胃食管反流患者管理的未来方向。
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来源期刊
Pharmacogenomics & Personalized Medicine
Pharmacogenomics & Personalized Medicine Biochemistry, Genetics and Molecular Biology-Molecular Medicine
CiteScore
3.30
自引率
5.30%
发文量
110
审稿时长
16 weeks
期刊介绍: Pharmacogenomics and Personalized Medicine is an international, peer-reviewed, open-access journal characterizing the influence of genotype on pharmacology leading to the development of personalized treatment programs and individualized drug selection for improved safety, efficacy and sustainability. In particular, emphasis will be given to: Genomic and proteomic profiling Genetics and drug metabolism Targeted drug identification and discovery Optimizing drug selection & dosage based on patient''s genetic profile Drug related morbidity & mortality intervention Advanced disease screening and targeted therapeutic intervention Genetic based vaccine development Patient satisfaction and preference Health economic evaluations Practical and organizational issues in the development and implementation of personalized medicine programs.
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