Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population‐Based Cohort Study
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2026
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| author | Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung |
| author_facet | Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung |
| collection | Wiley Open Access |
| contents | Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population‐Based Cohort Study Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung Journal of Gastroenterology and Hepatology ABSTRACT Background We determined the outcomes of Helicobacter pylori (HP) eradication on fracture risk. Methods This was a retrospective cohort study of patients who had received clarithromycin‐based triple therapy for HP infection or undergone upper endoscopy with no HP infection found (HP negative) between 2003 and 2012 in Hong Kong. Patients were divided into three groups: (i) HP‐negative, (ii) successful HP eradication, and (iii) delayed/failed HP eradication, and were observed till fracture development, death, or end of study. Propensity score (PS) adjustment was performed to account for ≥ 20 covariates (age, sex, comorbidities, and time‐varying medication use). Following the establishment of PS‐matched cohorts, the hazard ratio (HR) of fracture with HP eradication outcome was calculated by a multivariable Cox model. Results Of 322 180 eligible patients, 250 978 (77.9%) were HP‐negative, 61 892 (19.2%) had successful HP eradication, and 9310 (2.9%) delayed/failed eradication. During a median follow‐up of 11.5 years (IQR: 8.8–14.2), 16 935 (5.3%) developed fracture (vertebra: 1825; hip: 8338; humerus: 2147; forearm: 4080; carpal/wrist: 545). Compared with the HP‐negative group, the successful HP eradication group did not have a higher fracture risk (HR: 1.02; 95% CI: 0.89–1.16). However, a higher fracture risk was observed in the delayed/failed HP eradication group (HR: 1.37; 95% CI: 1.21–1.56). Among delayed/failed HP eradication patients with and without prior history of gastric ulcer, the HR was 2.21 (95% CI: 1.10–4.45) and 1.35 (95% CI: 1.19–1.54), respectively. Conclusion When compared with HP‐negative individuals, only HP‐positive patients with delayed/failed HP eradication had a higher fracture risk, particularly in those with a prior history of gastric ulcer. These results may suggest a potential protective association of successful HP eradication and subsequent fracture risk. 10.1111/jgh.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/jgh.70310 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_jgh_70310 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population‐Based Cohort Study Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung Journal of Gastroenterology and Hepatology Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population‐Based Cohort Study Jing Tong Tan Xianhua Mao Ching‐Lung Cheung Poh Hwa Ooi Wai‐Kay Seto Wai‐K. Leung Ka‐Shing Cheung Journal of Gastroenterology and Hepatology ABSTRACT Background We determined the outcomes of Helicobacter pylori (HP) eradication on fracture risk. Methods This was a retrospective cohort study of patients who had received clarithromycin‐based triple therapy for HP infection or undergone upper endoscopy with no HP infection found (HP negative) between 2003 and 2012 in Hong Kong. Patients were divided into three groups: (i) HP‐negative, (ii) successful HP eradication, and (iii) delayed/failed HP eradication, and were observed till fracture development, death, or end of study. Propensity score (PS) adjustment was performed to account for ≥ 20 covariates (age, sex, comorbidities, and time‐varying medication use). Following the establishment of PS‐matched cohorts, the hazard ratio (HR) of fracture with HP eradication outcome was calculated by a multivariable Cox model. Results Of 322 180 eligible patients, 250 978 (77.9%) were HP‐negative, 61 892 (19.2%) had successful HP eradication, and 9310 (2.9%) delayed/failed eradication. During a median follow‐up of 11.5 years (IQR: 8.8–14.2), 16 935 (5.3%) developed fracture (vertebra: 1825; hip: 8338; humerus: 2147; forearm: 4080; carpal/wrist: 545). Compared with the HP‐negative group, the successful HP eradication group did not have a higher fracture risk (HR: 1.02; 95% CI: 0.89–1.16). However, a higher fracture risk was observed in the delayed/failed HP eradication group (HR: 1.37; 95% CI: 1.21–1.56). Among delayed/failed HP eradication patients with and without prior history of gastric ulcer, the HR was 2.21 (95% CI: 1.10–4.45) and 1.35 (95% CI: 1.19–1.54), respectively. Conclusion When compared with HP‐negative individuals, only HP‐positive patients with delayed/failed HP eradication had a higher fracture risk, particularly in those with a prior history of gastric ulcer. These results may suggest a potential protective association of successful HP eradication and subsequent fracture risk. 10.1111/jgh.70310 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population‐Based Cohort Study |
| topic | Journal of Gastroenterology and Hepatology |
| url | https://onlinelibrary.wiley.com/doi/10.1111/jgh.70310 |