Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands

Dunnewind, Tom; Dvortsin, Evgeni; Smeets, Hugo M.; Konijn, Rob M.; Bos, Jens; Boer, Pieter T. de; Bergh, Joop van den; Postma, Maarten J.

doi:10.1016/j.jval.2017.02.006

Cited by 16 publications

(15 citation statements)

References 17 publications

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“…Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. 1 2 3 4 The prevalence of osteoporosis is expected to increase significantly in the future because of aging of the population. 5 6 Osteoporosis mainly occurs in postmenopausal women and elderly men.…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis: Current Concepts

Akkawi

Zmerly

2018

Joints

266

202

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Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measurement of BMD of the hip and spine using dual energy X-ray absorptiometry. According to the World Health Organization criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviation or more below the average value for young healthy women. Bone turnover biomarker detection may be useful in monitoring osteoporosis treatment and assessing fracture risk but not for diagnosis of osteoporosis. Management of osteoporosis consists of nonpharmacological interventions, which are recommended for all subjects, and pharmacological therapy in all postmenopausal women who have had an osteoporotic fracture or have BMD values consistent with osteoporosis.

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Section: Introductionmentioning

confidence: 99%

Osteoporosis: Current Concepts

Akkawi

Zmerly

2018

Joints

266

202

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“…Osteoporosis (OP) is a chronic bone metabolism disease that is clinically characterized by both bone mass reduction and bone architecture alteration. OP increases bone fragility and fracture risk worldwide (1,2). With the ageing of the population, particularly in Asia, the number of individuals who are aged ≥65 is projected to be 9.3% in 2025 (3).…”

Section: Introductionmentioning

confidence: 99%

Osteoking improves OP rat by enhancing HSP90‑β expression

et al. 2020

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Osteoporosis (OP) is a chronic bone disease that affects individuals worldwide. Osteoporosis is primarily asymptomatic, and patients with OP suffer from pain, inconvenience, economic pressure and osteoporotic fracture (OPF). Osteoking, a Traditional chinese Medicine compound that originates from the Yi ethnic group, has been used for a number of years to treat fractures. In our previous study, osteoking exhibited therapeutic effects on rats with OPF by promoting calcium deposition. Based on bioinformatics and network pharmacology analyses of a component-target-disease database, heat shock protein HSP 90-β (HSP90-β), also known as HSP90-β, was identified to be a key target of osteoking in OP. High HSP90-β expression levels were observed in osteoporotic rats and rat bone mesenchymal stem cells (rBMScs) following osteoking treatment. After 12 weeks of administration in vivo, there was increased bone mineral density (BMd) (P<0.05), increased bone alkaline phosphatase (P<0.05), and improved bone microstructure in the osteoking group compared with those of the negative control group. In vitro, increased calcium deposition in rBMScs was observed after 4 weeks of osteoking treatment. These results suggest that the mechanisms of osteoking are closely associated with HSP90-β and activate the bone morphogenetic protein (BMP) signalling pathway, primarily through BMP-2. Osteoking treatment improves OP in rats by enhancing HSP90-β expression.

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“…The ultimate goal of osteoporosis care is to reduce fractures and its consequences, such as disability and pain. There is discussion about how to decrease the current treatment gap, i.e., the fact that a large and increasing proportion of men and women at high-risk for fractures do not receive antiosteoporosis medication [1,2]. Although anti-osteoporosis medication has been proven to be effective in placebocontrolled trials [3,4], and tools are available to identify persons at high-risk [5], it is not clear whether screening for high fracture risk in the general population is effective in reducing fractures.…”

Section: Introductionmentioning

confidence: 99%

Fracture prevention by screening for high fracture risk: a systematic review and meta-analysis

et al. 2019

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This systematic review and meta-analysis showed a significant reduction of (major) osteoporotic fractures and hip fractures after screening using fracture risk assessment and bone densitometry compared with usual care. The results indicate that screening is effective for fracture risk reduction, especially hip fractures. To perform a systematic review and meta-analysis of population screening for high fracture risk on fracture prevention compared with usual care. MEDLINE and Embase were searched for studies published until June 20th 2019. Randomized studies were selected that screened for high fracture risk using at least bone densitometry, screened in a general population, provided subsequent treatment with anti-osteoporosis medication, had a usual care group as comparator, and had at least one fracture-related outcome (all fractures, (major) osteoporotic fractures, or hip fractures). The primary assessment was the hazard ratio (HR) for fracture-related outcomes. All-cause mortality was a secondary outcome. Random-effects models were used to estimate pooled HRs. We identified 1186 potentially eligible articles and included three randomized studies: the ROSE study, the SCOOP study, and the SOS with a total number of N = 42,009 participants. Respectively, 11%, 15%, and 18% of the participants in the intervention group started medication. Meta-analysis showed a statistically significant and clinically relevant reduction of osteoporotic fractures (HR = 0.95, 95% confidence interval (CI) = 0.89-1.00), major osteoporotic fractures (HR = 0.91; 95%CI = 0.84-0.98), and hip fractures (HR = 0.80; 95%CI = 0.71-0.91), but no reduction of all fractures (HR = 0.95; 95%CI = 0.89-1.02). The pooled HR for the secondary outcome all-cause mortality was 1.04 (95% CI = 0.95-1.14). Numbers needed to screen to prevent one fracture were 247 and 272 for osteoporotic fractures and hip fractures, respectively (corresponding to 113 and 124 performed bone densitometry examinations, and 25 and 28 persons being treated). This meta-analysis showed that population screening is effective to reduce osteoporotic fractures and hip fractures. Implementation of screening in older women should be considered as serious option to prevent osteoporotic fractures, especially hip fractures.

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Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands

Abstract: The estimated total costs corrected for treatment gap were €1.15 to €1.64 billion. These results indicate room for improvement in the health care policy against osteoporosis.

Cited by 16 publications

References 17 publications

Osteoporosis: Current Concepts

Osteoporosis: Current Concepts

Osteoking improves OP rat by enhancing HSP90‑β expression

Fracture prevention by screening for high fracture risk: a systematic review and meta-analysis

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