Abstract
Objective: To determine whether cytochrome P450 (CYP)2C19 haplotype associates with lansoprazole-associated adverse event frequency. Study design: Respiratory adverse events from a clinical trial of lansoprazole in children with asthma were analyzed for associations with extensive or poor metabolizer (PM) phenotype based on CYP2C19 haplotypes. Carriers of CYP2C19*2, *3,*8, or*9 alleles were PMs; carriers of 2 wild-type alleles were extensive metabolizers (EMs). Plasma concentrations of lansoprazole were determined in PM and EM phenotypes. Results: The frequency of upper respiratory infection among PMs (n = 45) was higher than that among EMs (n = 91), which in turn was higher than that in placebo subjects (n = 135; P =.0039). The frequency of sore throat (ST) was similarly distributed among EMs and PMs (P =.0015). The OR (95% CI) for upper respiratory infections in PMs was 2.46 (1.02-5.96) (P =.046); for EMs, the OR (95% CI) was 1.55 (0.86-2.79). The OR (95% CI) for ST in EMs and PMs was 2.94 (1.23-7.05, P =.016) vs 1.97 (1.09-3.55, P =.024), respectively. Mean ± SD plasma concentrations of lansoprazole were higher in PMs than in EMs: 207 ± 179 ng/mL vs 132 ± 141 ng/mL (P =.04). Conclusions: Lansoprazole-associated upper respiratory infections and ST in children are related in part to CYP2C19 haplotype. Our data suggest that lansoprazole-associated adverse events in children may be mitigated by adjusting the conventional dose in PMs. Additional studies are required to replicate our findings.
Original language | English (US) |
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Pages (from-to) | 686-691 |
Number of pages | 6 |
Journal | Journal of Pediatrics |
Volume | 163 |
Issue number | 3 |
DOIs | |
State | Published - Sep 2013 |
Keywords
- CYP
- Cytochrome P450
- EM
- Extensive metabolizer
- PM
- PPI
- Poor metabolizer
- Proton pump inhibitor
- SNP
- ST
- Single nucleotide polymorphism
- Sore throat
- URI
- Upper respiratory tract infection
- WT
- Wild type
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health