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Health Sciences › Medicine › Gastroenterology
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing
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Paper Summary
Conflicts of Interest
Identified Weaknesses
Rating Explanation
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Paper Summary
Paperzilla title
Genotype Matters: Tailoring Your PPI Dose for Better Heartburn Relief!
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.
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 Weaknesses
Limited generalizability
Most of the studies included in the review were conducted in Asian populations, limiting the generalizability of the findings to other ethnic groups.
Limited scope
The guideline focuses primarily on first-generation PPIs, with limited evidence for second-generation PPIs, making it difficult to provide comprehensive recommendations for all PPI types.
Lack of guidance on drug interactions
The review acknowledges the potential for drug-drug-gene interactions but does not provide specific guidance on managing these interactions, which could be clinically relevant.
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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Topic Hierarchy
File Information
Original Title:
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing
File Name:
download.pdf
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File Size:
0.08 MB
Uploaded:
July 14, 2025 at 11:13 AM
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