Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

Harvey, Nicholas C.; McCloskey, Eugène; Mitchell, P. J.; Dawson‐Hughes, Bess; Pierroz, Dominique D.; Reginster, Jean‐Yves; Rizzoli, René; Cooper, Cyrus; Kanis, John А.

doi:10.1007/s00198-016-3894-y

Cited by 185 publications

(137 citation statements)

References 121 publications

(140 reference statements)

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“…Fragility fractures lead to excess mortality and subsequent fractures, including hip fractures and vertebral fractures. Several anti‐osteoporosis medications have proved to effectively reduce the fracture risk. Prevention of new fractures is important for patients with fragility hip fractures.…”

Section: Discussionmentioning

confidence: 99%

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Wang

Zhuang

et al. 2019

Orthopaedic Surgery

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ObjectiveTo study the effect of anti‐osteoporosis therapies on mortality after hip fracture.MethodsThis retrospective study was carried out in the Second Affiliated Hospital of Fujian Medical University and enrolled 690 patients 50 years of age and older who were admitted with hip fractures between 2010 and 2015. The patients were followed in 2017: 690 patients aged was from 50 to 103 years. There were 456 women and 234 men. There were 335 patients with fractures of the femoral neck and 355 patients with intertrochanteric fractures of the femur. There were 444 (64.35%) patients who also had internal diseases. The Charlson comorbidity index was 0–6. The anti‐osteoporosis medications were classified into no anti‐osteoporosis medication, calcium + vitamin D supplementations, non‐bisphosphonate medication, and bisphosphonate medication. The physicians followed the patients or family members by personal visit and telephone. Multivariable Cox regression analyses were done with known risk factors for mortality of hip fracture, such as gender, age, number of combined internal diseases, fracture type, place of residence, and Charlson comorbidity index, to show which anti‐osteoporosis medications had significant effects on mortality after adjustment for these variables.ResultsOut of 690 patients with hip fractures, 149 patients received no anti‐osteoporosis medication, 63 patients received calcium +vitamin D supplementations, 398 patients received non‐bisphosphonate medication, and 80 patients received bisphosphonate medication. The patients were followed between 7 months and 52 months, with the average of 28.53 ± 9.75 months. A total of 166 patients died during the follow‐up period. Of 166 deaths, 43 occurred within 3 months, 65 within 6 months, and 99 within 1 year after the hip fracture. In this study, fracture type, place of residence, and Charlson comorbidity index were not associated with the mortality, and the male gender, age > 75 years, and ≥ 2 combined internal diseases were the independent factors for deaths post‐hip fracture. The cumulative mortality was 36.24% in the patients receiving no anti‐osteoporosis medication. The hazard ratio for mortality after hip fracture with bisphosphonate medication, non‐bisphosphonate medication, and calcium/vitamin D supplementation was 0.355 (95% CI, 0.194–0.648), 0.492 (95% CI, 0.347–0.699) and 0.616 (95% CI, 0.341–1.114), respectively, as compared with no anti‐osteoporosis group. Bisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with the reduction of cumulative mortality post‐hip fracture (P < 0.01).ConclusionsBisphosphonate and non‐bisphosphonate medications for osteoporosis were significantly associated with decreased mortality after fragility hip fracture.

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Section: Discussionmentioning

confidence: 99%

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Wang

Zhuang

et al. 2019

Orthopaedic Surgery

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“…As few as 10% of women with an osteoporotic fracture receive appropriate therapy . Fracture liaison services (FLSs) are a proven model of care that prevent osteoporotic fractures .…”

Section: Pharmacologic Managementmentioning

confidence: 99%

Osteoporosis in Older Persons: Old and New Players

Zanker

Duque

2018

J American Geriatrics Society

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Osteoporosis is the most common bone disease in humans. Older persons are at higher risk of osteoporotic fractures that also result in poor quality of life, disability, loss of independence, institutionalization, and higher mortality. Osteoporosis shares a distinct pathophysiologic relationship with sarcopenia, an age‐related disease comprising declines in muscle mass, strength, or function. The combination of these two diseases is known as osteosarcopenia. Understanding the pathophysiology of osteosarcopenia, in addition to its diagnostic and therapeutic approaches, is key in providing older adults with the best falls and fractures prevention strategies. This review provides updated information on new discoveries on the combined pathophysiology of osteoporosis and sarcopenia that have led to the development of novel therapeutic approaches. New recommendations for the use of risk calculators and densitometry are also presented in this review as well as evidence on current and upcoming pharmacologic treatments to prevent falls and fractures in older persons. J Am Geriatr Soc 67:831–840, 2019.

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“…Nonetheless, international medical-oriented research on osteoporosis reveals consequences of osteoporosis in everyday life for social living conditions, quality of life, and well-being (Koleck et al, 2006;Wilson et al, 2012;Kristensen et al, 2017). Patient awareness and prevention efforts have also been highlighted in that kind of literature (Jensen et al, 2016;Harvey et al, 2017). Women's vulnerability to the disease has been the focus of several long-term studies (Gold, 1996;Blakeley et al, 2000;Curry et al, 2002;Chan & Ko, 2005;Svejme, 2013).…”

Section: Act On Support and Services For Persons With Certain Functmentioning

confidence: 99%

Osteoporosis Patients with Fall-Related Injuries in Residential Environments: Challenges for Social Work

Lundälv¹

2018

IJSW

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The study describes the osteoporosis patient's need of support from medical social workers because of risks and injury events in residential environments. The study includes qualitative interviews of patients and a survey of medical social worker visibility in the media. Findings show that patients feel a lack of knowledge, recognition, and moral respect from the environment. Support from a medical social worker is significant, and activation in a patient association and an osteoporosis school is seen as employing valuable information channels. However, these have a fairly limited visibility in the media, when it comes to describing support opportunities and preventive work.

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Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

Cited by 185 publications

References 121 publications

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Anti‐Osteoporosis Medications Associated with Decreased Mortality after Hip Fracture

Osteoporosis in Older Persons: Old and New Players

Osteoporosis Patients with Fall-Related Injuries in Residential Environments: Challenges for Social Work

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