In:
Alimentary Pharmacology & Therapeutics, Wiley, Vol. 43, No. 10 ( 2016-05), p. 1048-1059
Abstract:
Acid inhibitory effects of proton pump inhibitors ( PPI s) are influenced by CYP 2C19 genotype. In contrast, the potent acid inhibition of vonoprazan is not influenced by CYP 2C19 genotype. Aim To compare the acid inhibitory effects of vonoprazan and esomeprazole in relation to CYP 2C19 genotype. Methods Twenty‐eight healthy Japanese volunteers [7 CYP 2C19 poor metabolisers ( PM s), 11 intermediate metabolisers ( IM s) and 10 rapid metabolisers ( RM s)] received four different regimens in a randomised crossover manner: (i) vonoprazan 20 mg twice daily (b.d.), (ii) vonoprazan 20 mg daily, (iii) esomeprazole 20 mg b.d. and (iv) esomeprazole 20 mg daily. The timing of each dosing was 1 h before a meal. Twenty‐four‐hour intragastric pH monitoring was performed on day 7 on each regimen. Results In the overall genotype group, pH ≥4 holding time ratios ( pH 4 HTR s) with vonoprazan b.d., vonoprazan daily, esomeprazole b.d. and esomeprazole daily were 100%, 95%, 91%, and 68% respectively. pH 5 HTR s were 99%, 91%, 84% and 54% respectively. Vonoprazan b.d. potently suppressed acid for 24 h, and was significantly superior to other regimens irrespective of CYP 2C19 genotype. Vonoprazan daily was equivalent to esomeprazole b.d. in IM s and PM s, but superior in RM s. CYP 2C19 genotype‐dependent differences were observed in esomeprazole daily but not in vonoprazan b.d. or daily. Conclusion Vonoprazan 20 mg b.d. inhibits acid irrespective of CYP 2C19 genotype, more potently than esomeprazole 20 mg b.d., pH 4 and 5 holding time ratios reached 100% and 99%, respectively.
Type of Medium:
Online Resource
ISSN:
0269-2813
,
1365-2036
DOI:
10.1111/apt.2016.43.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2003094-0
SSG:
15,3
Permalink
