PPIs are extensively metabolized in the liver, and the buy Ku-0059436 rate of metabolic inactivation is determined by genetic polymorphisms of CYP2C19. The plasma concentration of PPIs after oral ingestion were significantly lower in entensive metabolizers (EMs) namely normal homozygotes and heterozygotes compared to poor metabolizers (PMs) namely mutant homozygotes. This study has the objective of determining whether CYP2C19 genotypes affect clinical responses to esomeprazole therapy in GERD patients as well as prevalence of PMs in a Malay population. Methods: Subjects

comprised Malays who met study criteria of clinical diagnosis of GERD. All enrolled patients received esomeprazole 40 mg daily for 4 weeks.

Baseline endoscopy was done to identify any lesions. Blood was taken for genotyping analysis and for esomeprazole drug levels (every week). The clinical response was assessed by a validated GERD questionnaire (interview method) selleck kinase inhibitor before and after the treatment. Results: 36 subjects were enrolled. 15 subjects had two wild type alleles, 18 had one mutant allele and 3 had two mutant alleles. Both allele and genotype frequencies in the sample were in accordance with the Hardy-Weinburg equilibrium (X2 = 15.77, p value = 0.07). The observed improvement in clinical response due to esomeprazole treatment in GERD was significant in the EM, non-variant and variant allele groups (Wilcoxon-Signed Ranks test, p < 0.001). No statistical difference next was observed for this clinical improvement between the non-variant and variant allele groups (Kruskal-Wallis test, p = 0.477). Conclusion: We conclude that the prevalence of PMs in Malay population is 6.6%. The improvement of clinical responses to esomeprazole therapy in GERD subjects was not influence by CYP2C19 genetic polymorphism. These results suggest that CYP2C19 genotype testing may not be useful in PPIs therapy in GERD among

Malay population. Key Word(s): 1. pharmacogenetics; 2. polymorphism; 3. GERD; Presenting Author: WAI KEUNG LEUNG Additional Authors: DANIELKH TONG, TERESA TONG, SIMONYK LAW Corresponding Author: WAI KEUNG LEUNG Affiliations: University of Hong Kong Objective: Patients with pre-neoplastic gastric lesions including intestinal metaplasia (IM) and dysplasia are at increased risk of developing gastric cancer. Endoscopic radiofrequency ablation (RFA) has been successfully used in the eradication of dysplasia and IM associated with Barrett’s esophagus. We tested the feasibility of using RFA for the treatment of dysplasia and IM in the stomach. Methods: Patients who had histologically confirmed gastric dysplasia or IM were recruited.