Estudio epidemiológico de factores de riesgo asociados a refractura en mujeres con fractura vertebral osteoporótica durante 10 años de seguimiento

Renedo, Raúl Javier García; Sousa, M. Mella; Rojas, M. Anaya; Enríquez, J. Hernández; Parra, P. García; Pérez, C. Fernández; Luís, P. Cano

doi:10.1016/s1132-8460(09)73463-4

Cited by 2 publications

(5 citation statements)

References 17 publications

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“…Despite the intrinsic limitations of indirect comparisons, they provide useful information when there is no head-to-head clinical evidence. 47 For this input, we used the risk of subsequent fractures with and without osteoporotic treatment reported by García-Renedo et al, 21 refracture in 77 women with initial vertebral fracture with and without antiresorptive therapy was evaluated over a time horizon of 10 years. Due to the limited sample size, deterministic, probabilistic and scenario sensitivity analyses were performed to assess the potential inherent uncertainty of this input.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 18–20 On the other hand, Spanish clinical data on the persistence of osteoporosis medication were considered to model the clinical and economic consequences of SOC. 21 , 22 …”

Section: Methodsmentioning

confidence: 99%

“…The risk of subsequent fragility fractures was taken from the study by García Renedo et al, in which a cohort of patients with a history of non-surgical fragility fracture was retrospectively assessed over a time horizon of 10 years. 21 The risk is assumed to be dependent whether patient are persistent or not to their anti-osteoporotic treatment.…”

Section: Methodsmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Fracture Liaison Services Compared with Standard of Care in the Secondary Prevention of Fragility Fractures in Spain

Naranjo¹,

Prieto-Alhambra²,

Sánchez-Martín³

et al. 2022

CEOR

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Purpose To assess the cost-effectiveness of a Fracture Liaison Service (FLS) compared with standard care for the secondary prevention of fragility fractures in Spain. Methods Patients with osteoporosis and an initial fragility fracture who were candidates to initiate osteoporosis treatment (mean age 65 years, 90.7% female) were included in the model. Disease progression was simulated with a Markov model through seven health states (with and without osteoporosis treatment, subsequent hip, vertebral, forearm and humerus fracture, and death). A time horizon of 10 years and a 6-month duration per cycle was set. Clinical, economic, and quality of life parameters were estimated from the literature and Spanish clinical practice. Resource use and treatment patterns were validated by an expert panel. The Spanish National Health System (SNS) perspective was adopted, taking direct costs (€; 2020) into account. Effectiveness was measured in life-years gained (LYG) and quality-adjusted life years gained (QALYs). A discount rate of 3% was applied to costs and outcomes. The uncertainty of the parameters was assessed using deterministic, scenario and probabilistic sensitivity analyses (1000 iterations). Results Setting up a FLS for the secondary prevention of fragility fractures in Spain would provide better osteoporosis treatment initiation and persistence. This would reduce subsequent fragility fractures, disutilities and deaths. FLS would have greater clinical benefits (0.008 and 0.082 LYG and QALY gained per patient, respectively) and higher costs (€563.69 per patient) compared with standard care, leading to an incremental cost-utility ratio of €6855.23 per QALY gained over the 10 years horizon. The sensitivity analyses showed limited dispersion of the base case results, corroborating their robustness. Conclusion From the SNS perspective and considering Spanish willingness-to-pay thresholds, the introduction of FLS for the secondary prevention of fragility fractures would be a cost-effective strategy.

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Section: Discussionmentioning

confidence: 99%

“… 10 , 18–20 On the other hand, Spanish clinical data on the persistence of osteoporosis medication were considered to model the clinical and economic consequences of SOC. 21 , 22 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Cost-Effectiveness Analysis of Fracture Liaison Services Compared with Standard of Care in the Secondary Prevention of Fragility Fractures in Spain

Naranjo¹,

Prieto-Alhambra²,

Sánchez-Martín³

et al. 2022

CEOR

View full text Add to dashboard Cite

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“…Consequently, axial musculoskeletal health is deduced to be affected by interskeletal and extraskeletal factors. In addition, development of vertebral fracture reportedly can contribute to the incidence of further spinal fractures in the future 15,16 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, development of vertebral fracture reportedly can contribute to the incidence of further spinal fractures in the future. 15,16 Spinal curvature is determined by the shape of the vertebral bodies and back muscle strength. Because of bone loss and postural changes, vertebral fractures can occur more readily in persons with osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine: Case Series

Sinaki

2012

Pain Practice

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Objective: The objective of this report is to raise awareness of the effect of strenuous yoga flexion exercises on osteopenic or osteoporotic spines. We previously described subjects with known osteoporosis in whom vertebral compression fractures (VCFs) developed after spinal flexion exercise (SFE) and recommended that SFEs not be prescribed in patients with spinal osteoporosis. Methods: This report describes 3 healthy persons with low bone mass and yoga-induced pain or fracture. Results: All 3 patients had osteopenia, were in good health and pain-free, and had started yoga exercises to improve their musculoskeletal health. New pain and fracture areas occurred after participation in yoga flexion exercises. Conclusions: The development of pain and complications with some flexion yoga positions in the patients with osteopenia leads to concern that fracture risk would increase even further in osteoporosis. Although exercise has been shown to be effective for improving bone mineral density and decreasing fracture risk, our subjects had development of VCFs and neck and back pain with yoga exercises. This finding suggests that factors other than bone mass should be considered for exercise counseling in patients with bone loss. The increased torque pressure applied to vertebral bodies during SFEs may be a risk. Exercise is effective and important for treatment of osteopenia and osteoporosis and should be prescribed for patients with vertebral bone loss. Some yoga positions can contribute to extreme strain on spines with bone loss. Assessment of fracture risk in older persons performing SFEs and other high-impact exercises is an important clinical consideration. n

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Estudio epidemiológico de factores de riesgo asociados a refractura en mujeres con fractura vertebral osteoporótica durante 10 años de seguimiento

Cited by 2 publications

References 17 publications

Cost-Effectiveness Analysis of Fracture Liaison Services Compared with Standard of Care in the Secondary Prevention of Fragility Fractures in Spain

Cost-Effectiveness Analysis of Fracture Liaison Services Compared with Standard of Care in the Secondary Prevention of Fragility Fractures in Spain

Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine: Case Series

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