{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:21:39Z","timestamp":1792794099249,"version":"4.5.0"},"reference-count":113,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Non\u2010\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n (\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n ), non\u2010nonsteroidal anti\u2010inflammatory drug (NSAID) peptic ulcer disease (PUD) is increasingly recognized as a distinct subgroup, but its proportion across clinical presentations remains unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n We aimed to estimate this proportion.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We searched MEDLINE, Embase and CENTRAL from their inception to March 2026 for observational studies. The primary outcome was the proportion of non\u2010\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n , non\u2010NSAID PUD among adults with overall, bleeding and perforated PUD. Random\u2010effects meta\u2010analysis of logit\u2010transformed proportions was performed using restricted maximum likelihood. Meta\u2010regression assessed associations with study year, country\u2010level\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n prevalence and region. Protocol registered in PROSPERO (CRD420251174202).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 92 studies (60,816 patients) from 32 countries were included. The pooled proportions of non\u2010\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n , non\u2010NSAID PUD cases were 13.0% (95% confidence interval [CI], 10.4\u201316.2) in overall PUD, 11.3% (95% CI, 8.8\u201314.4) in bleeding PUD, and 22.0% (95% CI, 13.1%\u201334.7%) in perforated PUD. In univariable meta\u2010regression, a more recent study year was associated with a higher proportion of bleeding PUD (\n \u03b2<\/jats:italic>\n \u2009=\u20090.076; 95% CI, 0.031\u20130.120). This association remained statistically significant after adjustment for country\u2010level\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n prevalence (\n \u03b2<\/jats:italic>\n \u2009=\u20090.070; 95% CI, 0.026\u20130.113). Lower\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n prevalence was also associated with a higher proportion after further adjustment for region (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.025; 95% CI, \u22120.046 to \u22120.005).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Non\u2010\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n , non\u2010NSAID PUD represents a non\u2010negligible but heterogeneous component of PUD. In bleeding PUD, exploratory ecological analyses suggest a temporal increase, potentially reflecting evolving etiologic patterns beyond\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n infection and NSAID exposure.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.70906","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:57:06Z","timestamp":1786348626000},"page":"1034-1045","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Meta\u2010Analysis: Prevalence of Non\u2010\n \n Helicobacter pylori<\/i>\n <\/scp>\n , Non\u2010\n NSAID<\/scp>\n Peptic Ulcer Disease"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4477-4238","authenticated-orcid":false,"given":"Jun","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Gastroenterological, General and Transplant Surgery Jichi Medical University Shimotsuke Tochigi Japan"},{"name":"Division of Community and Family Medicine Jichi Medical University Shimotsuke Tochigi Japan"},{"name":"Department of Medicine, Division of Gastroenterology and Farncombe Family Digestive Health Research Institute McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7438-3909","authenticated-orcid":false,"given":"Hiromi","family":"Sekiguchi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology Jichi Medical University Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7305-5924","authenticated-orcid":false,"given":"Takeshi","family":"Kanno","sequence":"additional","affiliation":[{"name":"R & D Division of Career Education for Medical Professionals, Medical Education Center Jichi Medical University Shimotsuke Tochigi Japan"},{"name":"Division of Gastroenterology Tohoku University Graduate School of Medicine Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4265-9949","authenticated-orcid":false,"given":"Keigo","family":"Misawa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology Jichi Medical University Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7867-5758","authenticated-orcid":false,"given":"Satoshi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology Jichi Medical University Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-3042","authenticated-orcid":false,"given":"Yuhong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Farncombe Family Digestive Health Research Institute McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3616-9292","authenticated-orcid":false,"given":"Paul","family":"Moayyedi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Farncombe Family Digestive Health Research Institute McMaster University Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0160-432X","authenticated-orcid":false,"given":"Tomonori","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology Jichi Medical University Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Masamune","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Graduate School of Medicine Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-2513","authenticated-orcid":false,"given":"Tomoari","family":"Kamada","sequence":"additional","affiliation":[{"name":"Department of Health Care Medicine Kawasaki Medical School General Medical Center Kurashiki Okayama 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