Statins Enhance the Potency of First Line Anti-Helicobacter Regimens to that of Second Line Regimens

Abstract

Background: Infection-related to Helicobacter pylori (HP) is one of the most common human bacterial infections, affecting about 50% of the human population. This bacterium causes chronic inflammation and eventually mucosal gastric metaplasia. Antibiotics are commonly used to eradicate Helicobacter pylori infection. Presumably, statins could increase the effectiveness of anti-HP regimens because of some anti-inflammatory and antibacterial properties attributed to these anti-lipidemic agents. Methods: Two hundred patients with both gastrointestinal symptoms and positive urease test were included. Patients were randomly divided into two equal groups with 100 cases. One group received pantoprazole 40 mg, twice per day (BD) + atorvastatin 40 mg, daily + bismuth subcitrate 240 mg, BD + Amoxicillin 1 g, BD + Levofloxacin 500 mg, daily and the other one received pantoprazole 40 mg BD + atorvastatin 40 mg, daily + bismuth subcitrate 240 mg, BD + Amoxicillin 1 g, BD + Clarithromycin (Fromilid) 500 mg, BD for two weeks. A stool antigen test for HP was performed one month after drug treatment ended, and the results were compared. Results: According to our findings, eradication of HP infection in both groups was 87%, and there was no statistically significant difference between the two groups (p-value = 1). Conclusion: The current study highlighted that adding atorvastatin to the first line anti-HP infection regimen could increase the potency and efficacy of the regimen to that of second-line regimen. Moreover, the addition of atorvastatin to the second line regimen did not bear any beneficial effect. Trial registration number: The Ethics Committee of Qom University of Medical Sciences approved the study protocol (ethical code: IR.MUQ.REC.1399.082); the study was also registered in the Iranian Registry of Clinical Trials (No. IRCT20200929048884N1). This study adheres to CONSORT guidelines.