Meta-Analysis: Inverse Association Between Helicobacter pylori Infection and Eosinophilic Oesophagitis.

2025-02-24
Alimentary pharmacology & therapeutics 61(7)
- Irene Spinelli
- Serena Porcari
- Chiara Esposito
- William Fusco
- Francesca Romana Ponziani
- Cristiano Caruso
- Edoardo Vincenzo Savarino
- Antonio Gasbarrini
- Giovanni Cammarota
- Marcello Maida
- Antonio Facciorusso
- Gianluca Ianiro

PubMed: 39991954
DOI: 10.1111/apt.70042

Study Design

Type: Meta-Analysis
Sample size: n = 821
Population: 19 studies including 1,704,821 subjects
Methods: Searched MEDLINE, Scopus and ISI Web of Science, through to November 2024; included studies reporting H. pylori infection in patients with and without EoE/EE; random-effects model to pool estimates

Rigorous Journal

Background

Exposure to Helicobacter pylori (H. pylori) has been associated with a decreased risk of eosinophilic oesophagitis (EoE).

Aim

The aim of this study is to determine the association between H. pylori infection and EoE in this updated meta-analysis.

Methods

We searched MEDLINE, Scopus and ISI Web of Science, through to November 2024. We included studies reporting the status of H. pylori infection in patients with and without EoE or oesophageal eosinophilia (EE). We used a random-effects model to pool estimates.

Results

We analysed 19 studies including 1.704.821 subjects. H. pylori infection was associated with a 46% lower risk of EoE/EE (OR: 0.54, 95% CI 0.43 to 0.67). Comparable findings were observed when subgrouping studies by location or design. There was a nonsignificant decrease in odds for EoE in paediatric patients exposed to H. pylori (OR 0.57, 95% CI 0.26 to 1.24), and in studies using serology to diagnose H. pylori (OR: 0.41, 95% CI 0.16 to 1.04). We found lower odds of EoE compared with the overall findings in studies that diagnosed H. pylori only by gastric biopsy (OR 0.43, 95% CI 0.25 to 0.74) and in those published after 2019 (OR 0.44, 95% CI 0.28 to 0.68).

Conclusions

Exposure to H. pylori was significantly associated with decreased odds of EoE/EE. As a stronger protective effect was found in more recent studies, the epidemiology of this association may evolve and deserve to be further monitored.