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

Caldas, María; Pérez-Aísa, Ángeles; Tepeš, Bojan; Keco-Huerga, Alma; Bujanda, Luís; Lucendo, Alfredo J.; Rodrigo, Luı́s; Vaira, Dino; Fernández-Salazar, Luis; Huguet, José María; Pérez-Lasala, Jorge; Jurecic, Natasa Brglez; Fadeenko, Galina; Barrio, Jesús; Areia, Miguel; Ortuño, Juan; Pellicano, Rinaldo; Leja, Mārcis; Molina–Infante, Javier; Богомолов, П. О.; Алексеенко, С. А.; Domínguez-Cajal, Manuel; Gómez‐Camarero, Judith; Ntouli, Vassiliki; Martínez-Domínguez, Samuel J; Ruiz-Zorrilla, Rafael; Núñez, Óscar; Сарсенбаева, А. С.; Almela, Pedro; Phull, Perminder; Espada, Marta; Puig, Ignasi; Nyssen, Olga P.; Mégraud, Françis; O’Morain, C.; Gisbert, Javier P.

doi:10.3390/antibiotics10080965

Cited by 6 publications

(4 citation statements)

References 44 publications

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“…Another large prospective cohort revealed slightly higher eradication rates in statin users than non‐statin group using empirical treatment (89% vs. 86%, OR 1.3; 95% CI 1.1–1.5, P = 0.002). 102 Larger clinical trials are needed to confirm the efficacy of adding statin in treatment regimen.…”

Section: Adjuvant Therapy For H Pylori Infectionmentioning

confidence: 99%

Management of Helicobacter pylori infection

2022

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Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diagnostic testing and treatment for H. pylori infection is recommended in patients with active or past history of peptic ulcer, chronic dyspepsia, chronic non-steroidal anti-inflammatory drugs (NSAID) or aspirin use, precancerous gastric lesions, gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma, family history of gastric cancer, family history of peptic ulcers, household family member having active H. pylori infection, iron deficiency anemia, idiopathic thrombocytopenic purpura, or vitamin B12 deficiency. Recommended first-line regimens for H. pylori eradication are classified according to clarithromycin resistance. In areas of high clarithromycin resistance (≥15%), we recommend 14-day concomitant therapy or 14-day bismuth quadruple therapy (BQT) as first-line regimen. In areas of low clarithromycin resistance (<15%), we recommend 14-day triple therapy or 14-day BQT as first-line treatment. Second-line regimens are 14-day levofloxacin triple therapy or 14-day BQT if BQT is not previously used. For patients with multiple treatment failure, antimicrobial susceptibility testing (AST) should be performed. If AST is not available, we recommend using antibiotics not previously used or for which resistance is unlikely, such as amoxicillin, tetracycline, bismuth, or furazolidone. High-dose potent proton pump inhibitor or vonoprazan is recommended to achieve adequate acid suppression. Probiotics can be used as an adjuvant treatment to reduce the side effects of antibiotics and enhance eradication rate.

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Section: Adjuvant Therapy For H Pylori Infectionmentioning

confidence: 99%

Management of Helicobacter pylori infection

2022

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“…The objective of this study was to assess whether the use of statins prescribed for cardiovascular prevention and chronically used, and prescribed concomitantly with an H. pylori eradication therapy could modify the effectiveness rates of eradication treatments with regard to (a) the type of eradication therapy, in both the empirical and culture-guided groups, or (b) the statins prescribed, and ultimately whether these statins would modify the AE rates (35). In order to analyze data, patients were further divided into two groups: the ones receiving statins during the eradication therapy and the non-statin consumers.…”

Section: European Registry On Helicobacter Pylori Management: Single-...mentioning

confidence: 99%

“…Caldas M., 2021 (35) To evaluate if the concomitant use of statins prescribed for cardiovascular prevention and chronically used could modify the effectiveness rates of H. pylori eradication therapies.…”

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European Registry on Helicobacter pylori Management (Hp-EuReg): Most relevant results for clinical practice

Nyssen¹,

Moreira²,

García-Morales³

et al. 2022

Front. Gastroenterol.

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BackgroundThe ideal treatment approach for H. pylori infection has not yet been defined; therefore, the most effective management strategies for adult patients need to be identified to ensure clinical practice is aligned with the best standard of care. Our aim was to perform a review of research studies from the European Registry on H. pylori management (Hp-EuReg) by synthesizing the most clinically relevant information from each published manuscript.MethodsAll research studies published between 2013 and 2022, evaluating any information related to H. pylori infection management within the Hp-EuReg, a long-term registry of routine clinical practice by gastroenterologists in Europe, were included in the review.ResultsOverall, 26 studies have been published to date, where 12 evaluated the overall European data and the remaining were performed locally among the 28 participating countries. Eighteen studies evaluated the effectiveness of first- and/or second-line treatment, where one focused on penicillin allergic patients, six focused on specific treatment schemes, one evaluated the role of statins as a concomitant drug when combined with the eradication therapy, one assessed the adverse event profile of treatments, one evaluated the bacterial antibiotic resistance trends, and a last one reported on the common mistakes in routine clinical practice of European gastroenterologists.ConclusionThe Hp-EuReg had a major influence on the routine clinical practice of European gastroenterologists, improving H. pylori eradication treatment success, allowing to make recommendations in line with the current consensus guidelines and potentially serving as a model for other diseases.

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“…Focusing on such previous studies, for instance, the Spanish group Hp-EuReg reported that the introduction of statins would not be sufficient to increase the H. pylori eradication rate. 3 However, other studies have shown that the addition of statins to the conventional clarithromycin-based triple therapeutic regimen significantly increased the H. pylori eradication rate and displayed direct antibacterial action, synergistic action with antibiotics, and the ability to trigger the host human immune system against H. pylori . 4 …”

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Considering the Long-Conflicting Topic of Empirical or Nonconventional Helicobacter pylori Eradication Regimens

Kountouras

2023

Gut and Liver

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To the Editor, Τo overcome the influence of Helicobacter pylori-linked antibiotic resistance, Na et al. 1 administered therapies based on susceptibility pretesting by multiplex polymerase chain reaction or sequencing records, although without culture, which have been proposed as more rational approaches than the empirical use of standard H. pylori treatment regimens. Specifically, in their retrospective study, 1 they reported that after the estimation of clarithromycin susceptibility, short-term (7 days) first-line H. pylori eradication regimens based on these multiplex polymerase chain reaction or sequencing records exhibited an overall high but suboptimal effectiveness; comparable results were also obtained by a 14-day eradication regimen. Moreover, the authors did not consider culture-based H. pylori susceptibility assessment for additional antibiotics, which may have influenced the H. pylori eradication rates.Beyond the empirical first-line H. pylori eradication studies considered by the authors, 1 a large number of published studies have investigated H. pylori eradication regimens, including empirical second-and third-line regimens and/or strategies against H. pylori-resistant strains. For instance, recent data has reported a suboptimal efficacy of empirical second-line H. pylori eradication regimens. 2 Thus, new therapeutic approaches are warranted.After reviewing the abovementioned literature (although probably impossible), which may generate iatrogenic or even possible economic bias, such studies appear to be conducted without any potential novelty. Thus, the researchers may address the developing novel approaches, thereby recommending more effective strategies and evading citing the formerly recognized and repetitive data of increasingly ineffective antibiotic empirical or non-empirical combinations introduced. These combinations, beyond other critical concerns, render such monotonous studies rather insufficient for the regular reader.Focusing on such previous studies, for instance, the Spanish group Hp-EuReg reported that the introduction of statins would not be sufficient to increase the H. pylori eradication rate. 3 However, other studies have shown that the addition of statins to the conventional clarithromycin-based triple therapeutic regimen significantly increased the H. pylori eradication rate and displayed direct antibacterial action, synergistic action with antibiotics, and the ability to trigger the host human immune system against H. pylori. 4 Concerning H. pylori-resistant strains, the mechanisms underlying this resistance represent a crucial topic that commonly forces investigators to experiment, sometimes blindly, by empirically administering several antibiotics in diverse regimens, occasionally giving the feeling of a musical medley that does not match, which can reduce the prestige of the underlying science. Thus, the researchers have to consider the diverse topics involved in the failure to eradicate H. pylori, such as novel H. pylori genotypes with high pathogenicity, unsuitable patien...

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

Cited by 6 publications

References 44 publications

Management of Helicobacter pylori infection

Management of Helicobacter pylori infection

European Registry on Helicobacter pylori Management (Hp-EuReg): Most relevant results for clinical practice

Considering the Long-Conflicting Topic of Empirical or Nonconventional Helicobacter pylori Eradication Regimens

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