A Comparative Study of Proton-Pump Inhibitor Tests for Chinese Reflux Patients in Relation to the CYP2C19 Genotypes

Backgrounds & Aims: Proton-pump inhibitor (PPI) test has been proposed as a valuable tool in the diagnosis of gastroesophageal reflux disease (GERD) in Western populations. We assumed that a higher prevalence of poor metabolizers in Chinese population might affect the diagnostic accuracy of a PPI test.

Methods: In this open-label, randomized trial, patients with symptoms suggestive of GERD were randomly assigned to receive a 2-week test with daily rabeprazole 40-mg or daily pantoprazole 80-mg after diagnostic endoscopy. Therapeutic response was assessed with a five-grade daily record. Genotypes of cytochrome P450 (CYP) 2C19 polymorphism were determined.

As described above

• Drug: rabeprazole
  20 mg bid for 14 days
  Other Name: Pariet
• Drug: pantoprazole
  pantoprazole 40 mg bid
  Other Name: Pantoloc

• Active Comparator: Rabeprazole
  Intervention: Drug: rabeprazole
• Active Comparator: pantoprazole
  Intervention: Drug: pantoprazole

Inclusion Criteria:

• Consecutive patients with symptoms suggesting GERD will be enrolled from gastroenterology outpatient clinics in our academic institute. The typical GERD symptom was defined as heartburn and/or regurgitation at least 3 episodes per week in recent 3 months.

Exclusion Criteria:

• Those who were under maintenance PPI treatment, have a medical contraindication to PPI therapy, report a history of peptic ulcer disease or gastrointestinal surgery, malignancy proven by endoscopy, or unwilling or unable to provide informed consent.