Efficacy of Standard Triple Therapy With or Without Statin in Helicobacter pylori Eradication: A Randomized Double-Blind Placebo-Controlled Trial
In brief
Atorvastatin raised Helicobacter pylori eradication by 10 percentage points
In a randomized trial of 138 treatment-naive patients, adding atorvastatin to 14 days of standard triple therapy increased eradication from 85.3% to 95.7%. No clinically significant difference in adverse events emerged, but the small trial leaves open whether the benefit holds across populations and antibiotic resistance patterns.
- Journal
- Helicobacter (Q1)
- Published
- 1 January 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Chitchai Rattananukrom, Punnaphol Waranophirun, Anupol Panitchote, Suda Vannaprasaht, Tanita Suttichaimongkol, Kookwan Sawadpanich, et al.
- PMID
- 42866928
- DOI
- 10.1111/hel.70171
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 25 October 2026): Double‑blind RCT, H. pylori eradication
Abstract
BACKGROUND AND AIMS: Standard triple therapy (STT) for Helicobacter pylori (H. pylori) infection has become suboptimal. Atorvastatin may improve eradication rates by promoting autophagy and reducing inflammation. This study aimed to evaluate the efficacy and safety of adjuvant atorvastatin with STT compared to STT alone for H. pylori eradication. METHODS: In this randomized, placebo-controlled trial, 138 treatment-naïve patients with H. pylori infection were randomized to two groups. The intervention group (n = 70) received a 14-day regimen of omeprazole, amoxicillin, clarithromycin, and atorvastatin (40 mg once daily). The control group (n = 68) received the same regimen with a matching placebo. The primary endpoint was H. pylori eradication, assessed by a urea breath test 4-6 weeks after treatment completion. Secondary endpoints included CYP2C19 and CYP3A4/5 genotypes, adverse events, and patient compliance. RESULTS: The eradication rate in the intervention group was significantly higher than in the control group in both the per-protocol (97.1% vs. 85.3%) and intention-to-treat (ITT) analyses (95.7% vs. 85.3%). The absolute risk difference for the ITT analysis was 10.4% (95% CI, 0.75 to 20.1; p = 0.03). The distribution of CYP2C19 and CYP3A4/5 genotypes was similar between groups. No clinically significant differences in adverse events were observed. CONCLUSION: Adjuvant therapy with atorvastatin combined with STT significantly improved H. pylori eradication rates without clinically significant adverse events. Further randomized controlled trials in diverse populations and with varying antibiotic resistance patterns are needed to better clarify the effects of statins on H. pylori treatment. TRIAL REGISTRATION: Thai Clinical Trial Registry, No. TCTR20220201001.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.