J Gastroenterol Hepatol
Timely H. pylori eradication may help protect bone health
Clinical takeaway: Prioritize confirmation of H. pylori eradication and prompt retreatment after initial failure—especially in patients with ulcer history or fracture risk—to potentially reduce long-term osteoporotic fractures.
A population-based cohort study suggests that Helicobacter pylori eradication timing matters—not just for gastric outcomes, but for bone health as well.
Researchers followed 322,180 adults in Hong Kong for a median of 11.5 years, comparing fracture risk among H. pylori–negative individuals, those with successful eradication, and those with delayed or failed therapy. Overall, 5.3% of participants developed a major osteoporotic fracture during follow-up.
After propensity-score matching and multivariable adjustment, successful eradication was not associated with increased fracture risk compared with H. pylori–negative controls (hazard ratio [HR], 1.02; 95% CI, 0.89–1.16). In contrast, patients with delayed or failed eradication had a 37% higher fracture risk(HR, 1.37; 95% CI, 1.21–1.56), equivalent to 1.52 additional fractures per 1,000 person-years.
Risk was especially pronounced among patients with a history of gastric ulcer (HR, 2.21). Hip fractures accounted for nearly half of all fractures (49%), underscoring the clinical impact.
In their conclusion, the authors noted that “only H. pylori–positive patients with delayed/failed eradication had a higher fracture risk,” adding that the findings “suggest a potential protective association of successful H. pylori eradication.”
Source: Tan JT, et al. (2026, March 8). J Gastroenterol Hepatol. Effects of Successful Versus Delayed/Failed Helicobacter pylori Eradication Therapy on Subsequent Fracture Risk: a Population-Based Cohort Study