Atorvastatin in combination with conventional antimicrobial treatment of Helicobacter pylori eradication: A randomized controlled clinical trial

Abstract

Background and AimHelicobacter pylori is one of the main causes of digestive diseases, which is difficult to treat and requires the administration of several antimicrobial agents. Considering the anti‐inflammatory and antibacterial effect of atorvastatin, the present study aimed at adding this agent to a four‐drug regimen in order to eradicate H. pylori.MethodsA total of 220 patients with H. pylori infection were included in the current randomized controlled clinical trial. In the current study, 110 patients in the control group received a 14‐day regimen of amoxicillin, clarithromycin, bismuth, and esomeprazole, and 110 patients in the intervention group received 40 mg of atorvastatin daily plus the antibiotic regimen for 14 weeks. The treatment results were evaluated 1 month later using H. pylori stool antigen test. Data were collected using checklist and analyzed using chi‐squared and Fisher's exact tests with spss version 18.ResultsHelicobacter pylori eradication rate in the intervention and control groups was 78.18% and 65.45%, respectively (P = 0.025), and there was a significant difference in terms of non‐ulcer dyspepsia between the groups (P = 0.049), but there was no significant difference in age, gender, and body mass index between the two groups (P < 0.05).ConclusionThe present study results showed that adding atorvastatin to the four‐drug regimen of omeprazole, clarithromycin, bismuth, and amoxicillin is effective in the eradication of H. pylori. Also, the addition of atorvastatin to H. pylori eradication therapy is more effective in patients with non‐ulcer dyspepsia.

AGA Clinical Practice Update on the Management of Refractory Helicobacter pylori Infection: Expert Review

“…There are also some promising data for nonantibiotic adjuncts, such as statins [47][48][49] and probiotics. [50][51][52][53][54] Regarding the latter, there is an increasing body of data supporting a benefit of probiotics containing Lactobacillus and Bifidobacterium on H pylori eradication success via an inhibitory effect as well as enhanced patient tolerance of H pylori eradication therapy resulting in improved adherence.…”

Atorvastatin in Helicobacter Pylori Treatment: A Randomized Controlled Trial and Review

“…On the other hand, it should be noted that the drug regimen used in the study of Shakerian et al, the is not recommended regimen in Iran (study place). However, the success rate of a treatment regimen is related to geographical area, age and sex, and as reported in the results of their study, the intervention and control groups were 78.18% and 65.65%, respectively 30 . Which was less than the results of the present study (80.9% and 80%).…”

“…The test results were tested a month later using H. pylori fecal antigen testing. H. pylori eradication rates in the intervention and control groups were 78.18% and 65.45%, respectively (p-value = 0.025) 30 . Comparing the two studies with the present study, it is found that adding statins to the 4-drug regimen containing clarithromycin increases the eradication rate of H. pylori, while in the therapeutic regimen used in the present study, clarithromycin was replaced by metronidazole, and adding statins does not statistically improve H. pylori eradication.…”

The Role of Statins on Helicobacter pylori Eradication: Results from the European Registry on the Management of H. pylori (Hp-EuReg)

“…However, evidence evaluating another quadruple therapy, the bismuth-amoxicillin-clarithromycin quadruple therapy, had previously provided conflicting results: Parsi and collaborators evaluated the effectiveness of adding simvastatin (10 or 20 mg once daily) to a 14-day treatment with this quadruple therapy and found no significant differences in treatment effectiveness between the statin and placebo groups, with the effectiveness being around 90% in both cases [ 37 ]. On the other hand, Sarkeshikian and collaborators found significantly better results with the addition of atorvastatin 40 mg once daily to 14-day bismuth-amoxicillin-clarithromycin quadruple therapy (increasing effectiveness from 65% to 78%) [ 38 ]. Although this increase in effectiveness might seem relevant, the effectiveness values obtained in both cases can be considered suboptimal; accordingly, possible factors explaining these insufficient results should be carefully addressed.…”