Abstract

Helicobacter pylori infection affects over half of the global population, with growing antibiotic resistance compromising traditional eradication strategies. This systematic review and meta-analysis evaluated the efficacy and safety of statins as adjunctive therapy in H. pylori eradication regimens. A comprehensive search was conducted across multiple electronic databases through October 2023, including randomized controlled trials and observational studies comparing statin-supplemented versus standard eradication regimens. The primary outcome was the H. pylori eradication rate, and secondary outcomes included adverse events and treatment adherence. The risk of bias was assessed using the RoB 2 tool, and random-effects meta-analyses were performed. Six studies (n = 11,472) met the inclusion criteria. The primary analysis showed a non-significant trend favoring statin therapy (OR 1.25, 95% CI 0.53-2.93; I² = 88%). Sensitivity analysis excluding one discordant study yielded a significant benefit (OR 1.69, 95% CI 1.14-2.49; I² = 49%). Adverse events were more frequent with statin therapy (OR 2.34, 95% CI 1.89-2.89; I² = 0%). Treatment adherence consistently exceeded 85% across all groups. While statin therapy shows promise as an adjunctive treatment for H. pylori eradication, the increased risk of adverse events warrants careful patient selection. Future research should focus on optimizing statin protocols and identifying patient subgroups most likely to benefit from this approach.

Key words: Helicobacter Pylori, statin; antimicrobial drug resistance, HMG-CoA reductase inhibitors