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. 2021 Aug 11;10(8):965.
doi: 10.3390/antibiotics10080965.

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

María Caldas  1 , Ángeles Pérez-Aisa  2 , Bojan Tepes  3 , Alma Keco-Huerga  4 , Luis Bujanda  5 , Alfredo J Lucendo  6 , Luis Rodrigo  7 , Dino Vaira  8 , Luis Fernández-Salazar  9 , Jose M Huguet  10 , Jorge Pérez-Lasala  11 , Natasa Brglez Jurecic  12 , Galina Fadeenko  13 , Jesús Barrio  14 , Miguel Areia  15 , Juan Ortuño  16 , Rinaldo Pellicano  17 , Marcis Leja  18 , Javier Molina-Infante  19 , Pavel Bogomolov  20 , Sergey Alekseenko  21 , Manuel Domínguez-Cajal  22 , Judith Gómez-Camarero  23 , Vassiliki Ntouli  24 , Samuel J Martínez-Domínguez  25 , Rafael Ruiz-Zorrilla  26 , Oscar Núñez  27 , Aiman Silkanovna Sarsenbaeva  28 , Pedro Almela  29 , Perminder Phull  30 , Marta Espada  1 , Ignasi Puig  31 , Olga P Nyssen  1 , Francis Mégraud  32 , Colm O'Morain  33 , Javier P Gisbert  1 ; the Hp-EuReg Investigators
Collaborators, Affiliations

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

María Caldas et al. Antibiotics (Basel). .

Abstract

Statins could increase the effectiveness of Helicobacter pylori eradication therapies due to their anti-inflammatory effect. The aim of this study was to analyze the impact of this therapeutic association in real life. This is a multicenter, prospective, non-interventional study aimed at evaluating the management of H. pylori by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap from 2013 to 2020. The association between statin use and H. pylori eradication effectiveness was evaluated through multivariate analysis. Overall, 9988 and 705 patients received empirical and culture-guided treatment, respectively. Overall, statin use was associated with higher effectiveness in the empirical group (OR = 1.3; 95%CI = 1.1-1.5), but no association was found with first-line treatment effectiveness (N = 7738); as an exception, statin use was specifically associated with lower effectiveness of standard triple therapy (OR = 0.76; 95%CI = 0.59-0.99). In the rescue therapy empirical group (N = 2228), statins were associated with higher overall effectiveness (OR = 1.9; 95%CI = 1.4-2.6). However, sub-analyses by treatment schemes only confirmed this association for the single-capsule bismuth quadruple therapy (OR = 2.8; 95%CI = 1.3-5.7). No consistent association was found between statin use and H. pylori therapy effectiveness. Therefore, the addition of statins to the usual H. pylori treatment cannot be currently recommended to improve cure rates.

Keywords: Helicobacter pylori; statins; treatment.

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Conflict of interest statement

Ángeles Pérez-Aisa has served as a speaker for Allergan. Luis Fernández-Salazar has received honoraria from Norgine, Janssen, and Tillots. Jesús Barrio has served as a speaker, as a consultant, or has received research or education funding from MSD, Abbvie, Takeda, Janssen, and Ferring. Pedro Almela has served as a speaker, a consultant, and an advisory member for or has received research funding from MSD, Abbvie, Takeda, Janssen, Gebro Pharma, Tillotts Pharma, and Biogen. Olga P. Nyssen has received research funding from Allergan. Francis Megraud received honoraria from Phathom (advisory meeting) and Biocodex (lecture fees) and commercial research funding from Aptalis. Javier P. Gisbert has served as speaker, consultant, and advisory member for or has received research funding from Mayoly, Allergan, Diasorin, Gebro Pharma, and Richen. The rest of the authors have no disclosures.

Figures

Figure 1
Figure 1
Flowchart of the patients included. N = number of patients treated. mITT = modified intention-to-treat analysis. PP = per protocol analysis.
Figure 2
Figure 2
mITT effectiveness according to statin-status and receiving each specific therapy. (A) Empirical approach: first-line. (B) Empirical approach: rescue lines. (C) Culture-guided approach: first-line. (D) Culture-guided approach: rescue lines. PPI = proton pump inhibitor. C = clarithromycin. A = amoxicillin. M = metronidazole. T = tinidazole. B = bismuth. Single-capsule * = three-in-one single capsule containing bismuth, tetracycline and metronidazole. L = levofloxacin. Tc = tetracycline. D = doxycycline. RF = rifabutine. Conc = concomitant administration. Seq = sequential administration.
Figure 3
Figure 3
Distribution of adverse event severity presented according to statin use and treatment line.
See this image and copyright information in PMC

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