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- W2010072856 abstract "Achieving good eradication rates of Helicobacter pylori is becoming a major difficulty worldwide.1 The recommended first-line option, consisting of triple therapy with a proton pump inhibitor, clarithromycin and amoxicillin, does not obtain optimal results.2 In this scenario, the publication of the clinical trial's promising results using simvastatin as adjuvant in the eradication of H. pylori, by Nseir and colleagues3 opens a new path that might help increase the eradication rate from below 80% up to 85–90%. The use of statins aiming to eradicate H. pylori is novel and the mechanism of action is still unknown; even though its bactericidal effect has not been demonstrated in vitro,4 some studies have shown the beneficial effect of statins in the management of different bacterial conditions5 and in the severity of gastritis.6 However, literature on the subject is still contradictory, and a large retrospective Taiwanese study including over 10 000 cases found no association between statin treatment and H. pylori eradication.7 All these published data demand for a larger comparative clinical trial on the effect of statins in H. pylori eradication. The question is if a suboptimal standard triple therapy should be used as comparator. Graham and Fischbach argued that the lack of effectiveness damns triple therapy as unethical in comparative studies.8 This low effectiveness has been blamed on an increase in clarithromycin resistance, but recent publications have suggested that eradication rates with standard triple therapy have been stable, but suboptimal, over the years.9, 10 Therefore, we have not been doing things correctly and we should start amending these acquired habits. However, when studying the unknown effect of adjuvants the design may require arms differing only in the use of the adjuvant. Declaration of personal and funding interests: None." @default.
- W2010072856 created "2016-06-24" @default.
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- W2010072856 date "2012-07-16" @default.
- W2010072856 modified "2023-09-27" @default.
- W2010072856 title "Commentary: comparators in H. pylori eradication - stating the ethics of statins" @default.
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- W2010072856 doi "https://doi.org/10.1111/j.1365-2036.2012.05191.x" @default.
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