T. Furuta, M. Sugimoto, M. Yamade, T. Uotani, S. Sahara, H. Ichikawa, T. Kagami, H. Watanabe, K. Umemura; Hamamatsu University School of Medicine, Hamamatsu, Japan
BACKGROUND: Different patients are infected with different strains of H. pylori (Hp) and have different metabolic capacity of medicines. In 2007, we introduced an automated SNP analyzer to our institution which determines patient CYP2C19 and bacterial 23S rRNA genotypes within 30 min to aid in the design of personalized therapy. Here, we present our results of the personalized therapy informed via SNP analysis in comparison with those without in the same period.
METHODS: We treated 235 patients who had never undergone the eradication therapy and 92 patients who failed with the standard first line therapy with personalized regimens based on patients' CYP2C19 and bacterial 23S rRNA genotypes determined using DNA extracted from gastric tissue or fluid by the automated SNP analyzer, GENE CUBE® (TOYOBO, Co., Ltd. Fukui, Japan). Results were compared with those by the standard first and second line therapies in Japan
RESULTS: ITT analyses found eradication rates to be 71.7% (109/152) with first-line standard regimens and 97.9% (230/235) with personalized regimens (P < 0.001). Rates were 79.2% (38/48) with second-line standard regimens and 94.6% (87/92) with personalized regimens (P=0.032). The rates were 87.7% for the third line therapy.
CONCLUSION: Personalized therapy of H. pylori infection based on genetic analysis resulted in higher eradication rates in first- and second-line therapies than with the standard therapy. Based on these results, and considering the continuing rapid advances in nucleotide sequencing technology, genotype-based personalized therapies may soon become the new standard treatment for H. pylori infection.