Login Register Cart 0
Generic placeholder image

Current Drug Therapy

Editor-in-Chief

ISSN (Print): 1574-8855
ISSN (Online): 2212-3903

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Clinical Trial

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

Author(s): Ahmad Hormati, Sajjad Ahmadpour*, Zeynab Rezaei, Gholam Reza Sivandzadeh, Mohammad Saeidi, Elham Jafari, Abolfazl Mohammadbeigi and Javad Khodadadi*

Volume 17, Issue 5, 2022

Published on: 11 August, 2022

Page: [369 - 375] Pages: 7

DOI: 10.2174/1574885517666220525121251

Price: $65

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.

Keywords: Helicobacter pylori, clarithromycin, levofloxacin, eradication efficacy, stool antigen test, second line regimen.

« Previous Next »
Graphical Abstract

[1]
Goodwin CS, McConnell W, McCulloch RK, et al. Cellular fatty acid composition of Campylobacter pylori from primates and ferrets compared with those of other campylobacters. J Clin Microbiol 1989; 27(5): 938-43.
[http://dx.doi.org/10.1128/jcm.27.5.938-943.1989] [PMID: 2745703]
[2]
De Falco M, Lucariello A, Iaquinto S, Esposito V, Guerra G, De Luca A. Molecular mechanisms of Helicobacter pylori pathogenesis. J Cell Physiol 2015; 230(8): 1702-7.
[http://dx.doi.org/10.1002/jcp.24933] [PMID: 25639461]
[3]
Roszczenko-Jasińska P, Wojtyś MI, Jagusztyn-Krynicka EK. Helicobacter pylori treatment in the post-antibiotics era-searching for new drug targets. Appl Microbiol Biotechnol 2020; 104(23): 9891-905.
[http://dx.doi.org/10.1007/s00253-020-10945-w] [PMID: 33052519]
[4]
Atherton JC. The pathogenesis of Helicobacter pylori-induced gastro-duodenal diseases. Annu Rev Pathol 2006; 1(1): 63-96.
[http://dx.doi.org/10.1146/annurev.pathol.1.110304.100125] [PMID: 18039108]
[5]
Hussein NR. Helicobacter pylori and gastric cancer in the Middle East: A new enigma? World J Gastroenterol 2010; 16(26): 3226-34.
[http://dx.doi.org/10.3748/wjg.v16.i26.3226] [PMID: 20614477]
[6]
Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345(11): 784-9.
[http://dx.doi.org/10.1056/NEJMoa001999] [PMID: 11556297]
[7]
Cover TL. Helicobacter pylori diversity and gastric cancer risk. MBio 2016; 7(1): e01869-15.
[http://dx.doi.org/10.1128/mBio.01869-15] [PMID: 26814181]
[8]
Park JY, Forman D, Waskito LA, Yamaoka Y, Crabtree JE. Epidemiology of Helicobacter pylori and CagA-positive infections and global variations in gastric cancer. Toxins (Basel) 2018; 10(4): 163.
[http://dx.doi.org/10.3390/toxins10040163] [PMID: 29671784]
[9]
Veres G, Pehlivanoglu E. Helicobacter pylori infection in pediatrics. Helicobacter 2007; 12 (Suppl. 1): 38-44.
[http://dx.doi.org/10.1111/j.1523-5378.2007.00532.x] [PMID: 17727459]
[10]
Sabbagh P, Mohammadnia-Afrouzi M, Javanian M, et al. Diagnostic methods for Helicobacter pylori infection: Ideals, options, and limitations. Eur J Clin Microbiol Infect Dis 2019; 38(1): 55-66.
[http://dx.doi.org/10.1007/s10096-018-3414-4] [PMID: 30414090]
[11]
Giannakis M, Chen SL, Karam SM, Engstrand L, Gordon JI. Helicobacter pylori evolution during progression from chronic atrophic gastritis to gastric cancer and its impact on gastric stem cells. Proc Natl Acad Sci USA 2008; 105(11): 4358-63.
[http://dx.doi.org/10.1073/pnas.0800668105] [PMID: 18332421]
[12]
Sarkeshikian SS, Ghadir MR, Alemi F, Jalali SM, Hormati A, Mohammadbeigi A. Atorvastatin in combination with conventional antimicrobial treatment of Helicobacter pylori eradication: A randomized controlled clinical trial. J Gastroenterol Hepatol 2020; 35(1): 71-5.
[http://dx.doi.org/10.1111/jgh.14810] [PMID: 31359499]
[13]
Hassan AM, Shawky MAE, Mohammed AQ, Haridy MA, Eid KA. Simvastatin improves the eradication rate of Helicobacter pylori: Upper Egypt experience. Infect Drug Resist 2019; 12: 1529-34.
[http://dx.doi.org/10.2147/IDR.S202346] [PMID: 31239728]
[14]
Garza-González E, Perez-Perez GI, Maldonado-Garza HJ, Bosques-Padilla FJ. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World J Gastroenterol 2014; 20(6): 1438-49.
[http://dx.doi.org/10.3748/wjg.v20.i6.1438] [PMID: 24587620]
[15]
Ramis IB, de Moraes EP, Fernandes MS, et al. Evaluation of diagnostic methods for the detection of Helicobacter pylori in gastric biopsy specimens of dyspeptic patients. Braz J Microbiol 2012; 43(3): 903-8.
[http://dx.doi.org/10.1590/S1517-83822012000300008] [PMID: 24031905]
[16]
Khalifehgholi M, Shamsipour F, Ajhdarkosh H, et al. Comparison of five diagnostic methods for Helicobacter pylori. Iran J Microbiol 2013; 5(4): 396-401.
[PMID: 25848511]
[17]
Hirschl AM, Makristathis A. Methods to detect Helicobacter pylori: From culture to molecular biology. Helicobacter 2007; 12 (Suppl. 2): 6-11.
[http://dx.doi.org/10.1111/j.1523-5378.2007.00560.x] [PMID: 17991170]
[18]
Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62(1): 34-42.
[http://dx.doi.org/10.1136/gutjnl-2012-302254] [PMID: 22580412]
[19]
Mégraud F, Lehours P. Helicobacter pylori detection and antimicrobial susceptibility testing. Clin Microbiol Rev 2007; 20(2): 280-322.
[http://dx.doi.org/10.1128/CMR.00033-06] [PMID: 17428887]
[20]
Bezminabadi AT, Mobarez AM, Ajami AGH, Rafiee A, Taghwaii T. Evaluation on antibiotic resistance of Helicobacter pylori isolated from patients admitted to Tooba Medical Center, Sari. J Mazandaran Univ Med Sci 2009; 19(70): 26-32.
[21]
Abadi ATB, Mobarez AM. The prevalence of antibiotic resistant Helicobacter pylori: A literature review. Govaresh 2018; 23(4): 213-24.
[22]
Azar MMH, Portaghali P, Sedokani A, Jafari A. Atorvastatin and standard treatment of Helicobacter pylori: Single blinded randomized controlled clinical trial. medRxiv 2020.
[23]
Mahdavi R, Nikpour S. The effect of atorvastatin on the eradication of Helicobacter pylori in patients attending a gastroenterology clinic of Loghman-e-Hakim Hospital PhD Thesis Shahid Beheshti University of Medical Sciences, Tehran, Iran 2014.
[24]
Nseir W, Diab H, Mahamid M, et al. Randomised clinical trial: Simvastatin as adjuvant therapy improves significantly the Helicobacter pylori eradication rate-a placebo-controlled study. Aliment Pharmacol Ther 2012; 36(3): 231-8.
[http://dx.doi.org/10.1111/j.1365-2036.2012.05161.x] [PMID: 22646167]

Rights & Permissions Print Cite
Article Metrics
20
3
© 2024 Bentham Science Publishers | Privacy Policy