Monitoring cytochrome P-450 activity during rabeprazole treatment in patients with gastroesophageal reflux disease.

Proton pump inhibitors (PPIs) are the cornerstone in the treatment of gastresophageal reflux disease (GORD). PPIs are metabolized by the hepatic cytochrome P-450 enzymes (CYP-450). Rabeprazole is a PPI whose metabolism shows fewer interactions compared to other PPIs. In this study we evaluated the influence of rabeprazole administration on hepatic CYP-450 activity as measured by the C-13-aminopyrine breath test (C-13-ABT) in a group of patients with GORD. C-13-ABT was performed on five GORD patients both before and after 1 week of rabeprazole administration (20 mg, b.i.d.). Pretreatment C-13-ABT results were compared to posttreatment results. Pre- and posttreatment C-13-ABT results for patients were compared to those obtained in five controls who did the test twice, with a 1-week interval in between. Before treatment, the C-13-ABT results for the GORD patients did not significantly differ from those of healthy subjects. After treatment, we observed no significant modification of the C-13-ABT in GORD patients compared to pretreatment values (C-13-ABT %dose/hr, 10.56 +/- 1.31 versus 11.17 +/- 0.88; C-13-ABT %cumulative dose, 8.08 +/- 1.11 versus 8.34 +/- 0.56). Posttreatment C-13-ABT results were not significantly different from those obtained in controls at weekly repetition of the test. In patients with GORD, 1-week, full-dose rabeprazole does not display any significant interactions with CYP-450 activity.