Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing
Overview
Paper Summary
This guideline recommends adjusting proton pump inhibitor (PPI) dosing based on a patient's CYP2C19 genotype to optimize efficacy and minimize adverse effects. Patients with genotypes predicting lower PPI exposure (rapid metabolizers) may benefit from higher doses, while those with genotypes predicting higher exposure (intermediate and poor metabolizers) may benefit from lower doses, especially during long-term therapy.
Explain Like I'm Five
Scientists found that some people's bodies break down stomach medicine differently. So, doctors might give you more or less medicine depending on how fast your body uses it, to make sure it works best.
Possible Conflicts of Interest
JAJ consults for United Health Group on pharmacogenomics implementation. SAS is employed by Sema4, a for-profit genetic testing company. DLT is employed by Translational Software, another for-profit genetic testing company offering pharmacogenetic testing. As an Associate Editor, Sara Van Driest was not involved in the review process.
Identified Limitations
Rating Explanation
This paper offers valuable, clinically relevant guidance on PPI dosing based on CYP2C19 genotype. While limited by its focus on first-generation PPIs and Asian populations, it addresses an important clinical need and is well-supported by existing evidence. The disclosed COIs are noted but do not appear to significantly compromise the integrity of the work.
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