SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacogenetics and Pharmacogenomics
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1572886
CYP2C19 Variability and Clinical Outcomes of Clopidogrel, Proton Pump Inhibitors, and Voriconazole in Southeast Asia: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Clinical Pharmacology Specialist Study Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Jakarta, Indonesia
- 2Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, Jakarta, Indonesia
- 3Metabolic, Cardiovascular, and Aging Cluster, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Jakarta, Indonesia
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This meta-analysis seeks to elucidate the variability of CYP2C19 in Southeast Asia and its clinical implication for various medications, including clopidogrel, proton pump inhibitors (PPIs), and voriconazole, based on the keywords "CYP2C19" and "Southeast Asia country." Based on 72 found studies, this meta-analysis revealed that CYP2C19 allele distribution in Southeast Asians is predominantly similar to that in East Asians, except for Indian Singaporeans and Malaysians, who match South and Middle Asians, and Papuans, who are similar to the Oceania population. CYP2C19 variation in Southeast Asian populations correlates with different treatment responses to clopidogrel and PPIs. The incidence of major adverse cardiovascular events (MACE), hypoaggregation, and clopidogrel resistance increased among clopidogrel users with CYP2C19 intermediate and poor metabolizer phenotypes. The effectiveness of PPIs treatment for Helicobacter pylori also tends to decrease in normal and intermediate metabolizers compared to poor metabolizers. Additional high-quality studies, including RCTs of pharmacogenetic testing, are essential to encourage CYP2C19 testing in Southeast Asia.
Keywords: CYP2C19, southeast asia, clopidogrel, Proton Pump Inhibitors, Voriconazole
Received: 11 Feb 2025; Accepted: 14 May 2025.
Copyright: © 2025 Hardi, Barinda, Mahata and Fitrianti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Agian Jeffilano Barinda, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta, 10430, Jakarta, Indonesia
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