CYPC19*17 POLYMORPHISM AS A RISK-FACTOR FOR NSAIDS-INDUCED ULCERS

The new risk-factors for peptic ulcers induced by the use of nonsteroidal antiinflammatory drugs, such as polymorphism of different isoenzymes of cytochrome P450 were considered in the article. The aim of the research was to study different genetic polymorphism of several ferments CYP2C9 and CYP2C19 in inclination to NSAIDS-gastropathies by the way of estimation the risk of appearance of Helicobacter pylori (HP)-positive or Hp-negative NSAIDS- induced peptic ulcers, complicated or not with upper gastrointestinal bleeding. 124 persons were examined (76 men, 48 women in the age of 56,2+/–9,1 years) with Hp-positive or Hp-negative NSAIDS-induced peptic ulcers, that were performed genotyping of isoferments of cytochrome system (CYP2C9, CYP2C19). Based on investigations of 5 different isoenzymes (CYP 2C9*2, CYP 2C9*3, CYP 2C19*2, CYP 2C19*3 and CYP 2C19*17). It was founded that peptic ulcers are strictly associated only with CYP 2C19*17-genotype, possibly due to its involvement in arachidonic acid metabolism and gastroprotection. Thus, polymorphism CYP 2C19*17 can be considered as one of the risk factors for NSAID-gastropathy though the future researches are needed.

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Individual Nonsteroidal Antiinflammatory Drugs and Other Risk Factors for Upper Gastrointestinal Bleeding and Perforation

Epidemiology ◽

10.1097/00001648-199701000-00003 ◽

1997 ◽

Vol 8 (1) ◽

pp. 18-24 ◽

Cited By ~ 145

Author(s):

Susanne Pérez Gutthann ◽

Luis A. GarcíaRodríguez ◽

Drusilla S. Raiford

Keyword(s):

Risk Factors ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Nonsteroidal Antiinflammatory Drugs ◽

Antiinflammatory Drugs ◽

Upper Gastrointestinal

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SMERNICE ZA PREPREČEVANJE IN ZDRAVLJENJE NEŽELENIH UČINKOV NESTEROIDNIH PROTIVNETNIH IN ANTIAGREGACIJSKIH UČINKOVIN NA PREBAVILA

Slovenian Medical Journal ◽

10.6016/zdravvestn.1171 ◽

2015 ◽

Vol 84 (1) ◽

Author(s):

Borut Štabuc ◽

Bojan Tepeš ◽

Pavel Skok ◽

Miroslav Vujasinović ◽

Aleš Blinc ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

High Risk ◽

Adverse Effects ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Nonsteroidal Antiinflammatory Drugs ◽

Antiinflammatory Drugs ◽

Risk Patients ◽

Upper Gastrointestinal

Adverse effects of nonsteroidal antiinflammatory drugs and antiaggregants on gastrointestinal tract can be prevented or reduced by rational prescribing, use of proton pump inhibitors and Helicobacter pylori eradication.Nonsteroidal antiinflammatory drugs should not be used to treat patients with high risk for serious adverse effects on either upper gastrointestinal or cardiovascular system. Proton pump inhibitors in standard oral dosages are used for treatment of dyspepsia or gastric and duodenal erosions and ulcers, caused by nonsteroidal antiinflammatory drug or antiaggregant use. Peptic ulcer hemorrhage is treated with endoscopic hemostasis and proton pump inhibitors (72-hour continuous infusion followed by 4 – 8 week standard dose oral treatment).Patients can be stratified into three groups based on risk for upper gastrointestinal system adverse effects associated with nonsteroidal antiinflammatory drugs or antiaggregants use. Absence of risk factors denotes low-risk patient population, one or two risk factors are associated with medium risk; high-risk patients harbor either three or more risk factors or history of complicated peptic ulcer disease. Helicobacter pylori should be eradicated (if present) in all medium and high-risk patients prior to introduction of nonsteroidal antiinflammatory drugs or antiaggregants and proton pump inhibitors in standard daily dose should be prescribed for the duration of the treatment.Risk of gastrointestinal hemorrhage should be considered when planning invasive cardiovascular procedures or introduction of antiaggregant or anticoagulant treatment. In the context of acute gastrointestinal hemorrhage, antiaggregants should not be discontinued for longer than 7 days and oral anticoagulant therapy should be stopped and converted to low-molecular-weight heparin after complete hemostasis.

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