Archives of Osteoporosis最新文献

{"title":"Prevalence of fractures in adults over 50 years of age with osteoporosis in Colombia","authors":"Néstor Correa-Gonzalez,&nbsp;Daniel G. Fernández-Ávila,&nbsp;Diego Rosselli","doi":"10.1007/s11657-024-01412-4","DOIUrl":"10.1007/s11657-024-01412-4","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>What are the fractures associated with osteoporosis in Colombian persons over 50 years of age? Through the analysis of the Ministry of Health databases, Colombians over 50 years of age with osteoporosis fracture the forearm the most, followed by the thoracolumbar vertebrae and then the hip. We describe the differences between men and women.</p><h3>Purpose</h3><p>The aim of this study was to determine the frequency of all bone fractures among adults aged 50 and above, both with and without osteoporosis, using data from SISPRO (Integrated Information System for Social Protection), the administrative database of the Colombian Ministry of Health.</p><h3>Methods</h3><p>Information was collected for the years 2017 to 2021 for all bone fractures (except cranial or face fractures), and how many of them occurred in patients who had the diagnosis of osteoporosis. Prevalence ratios (PR) were estimated separately for males and females by dividing the prevalence in those with by the prevalence of those without osteoporosis.</p><h3>Results</h3><p>For the period from 2017 to 2021, 303,037 adults over 50 years of age (females 279,057, 92.1%) were diagnosed with osteoporosis in Colombia, for a prevalence of 39.4 per thousand women and 4.14 in men; 40,823 of these women (14.6%) presented a fracture in the period, as well as 4020 of men (16.7%). Osteoporosis was present in 7.5% of the 596.618 (females 369.795; 62.0%) who suffered any fracture (1.8% of males and 11.0% of females). Overall PR was 3.4 (males 4.3; females 3.3). In men with osteoporosis, the most frequent fractures were hip (902), followed by lumbar vertebrae (842), ribs (648), and forearm (538), while in women, forearm (11,001), followed by hip (6885), lumbar vertebra (4813), and thoracic vertebra (2701) were the most common. PR in men was 21.9 for dorsal vertebrae fracture, 21.3 for lumbar vertebrae, 11.8 for ribs, and 7.7 for hip fracture. In women, PR was 15.7 for thoracic vertebrae, 13.3 for lumbar vertebrae, 3.3 for hip fracture, and 2.2 for forearm fracture.</p><h3>Conclusion</h3><p>Osteoporosis is a highly prevalent disease in Colombia where women are more affected. Although fractures were more common in women, men with osteoporosis have a higher PR of associated fractures.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Incidence and excess mortality of hip fractures in a predominantly Caucasian population in the South of Brazil","authors":"Dalisbor Marcelo Weber Silva,&nbsp;Marise Lazaretti-Castro,&nbsp;Cristiano Augusto de Freitas Zerbini,&nbsp;Vera Lúcia Szejnfeld,&nbsp;Sergio Ragi Eis,&nbsp;Victoria Zeghbi Cochenski Borba","doi":"10.1007/s11657-024-01416-0","DOIUrl":"10.1007/s11657-024-01416-0","url":null,"abstract":"","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of healthcare providers on osteoporosis, falls and fracture risk: a systematic review and thematic synthesis of qualitative studies","authors":"Catherine Cho,&nbsp;Grace Bak,&nbsp;Daniel Sumpton,&nbsp;Bethan Richards,&nbsp;Catherine Sherrington","doi":"10.1007/s11657-024-01446-8","DOIUrl":"10.1007/s11657-024-01446-8","url":null,"abstract":"<div><h3>Objective</h3><p>Osteoporosis and falls are major risk factors for osteoporotic fractures, with significant detriment to patients’ quality of life. We aimed to describe healthcare provider (HCP) perspectives and experiences in the diagnosis, management and prevention of osteoporosis, falls and fractures obtained through primary qualitative research.</p><h3>Methods</h3><p>Thematic synthesis was performed on articles identified through a search of electronic databases (MEDLINE, Embase, PsychINFO and CINAHL), which were searched from inception to May 2023.</p><h3>Results</h3><p>Twenty-seven studies including 1662 HCPs, including general practitioners (GPs), physicians, surgeons, physiotherapists (PTs), occupational therapists (OTs), pharmacists and nurses, were included, with identification of six themes: overshadowed as a disease entity, uncertainty in decision making, frustration with interdisciplinary and systemic tension, avoiding medical paternalism, desire for improved care and embracing the responsibility.</p><h3>Conclusion</h3><p>Osteoporotic fracture and fall prevention in routine clinical care is hampered by inadequate priority and lack of perceived connection with morbidity and mortality, deficits in interdisciplinary collaboration, lack of clinical confidence and health resourcing. However, HCPs acknowledge their role in promoting healthy ageing, thus providing support through appropriate continuing education, resourcing and public health campaigns that are significant future directions, which may improve osteoporotic fracture prevention.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of teriparatide vs. bisphosphonates and denosumab vs. bisphosphonates in osteoporosis not previously treated with bisphosphonates: a systematic review and meta-analysis of randomized controlled trials","authors":"Mingnian Li,&nbsp;Zhuoqi Ge,&nbsp;Benqi Zhang,&nbsp;Li Sun,&nbsp;Zhongyuan Wang,&nbsp;Tao Zou,&nbsp;Qi Chen","doi":"10.1007/s11657-024-01447-7","DOIUrl":"10.1007/s11657-024-01447-7","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>The study found that in osteoporosis patients who had not previously received bisphosphonate treatment and were in a treatment cycle of over 12 months, both teriparatide and denosumab significantly increased bone mineral density compared to bisphosphonates. Additionally, teriparatide was also shown to significantly decrease the risk of fractures.</p><h3>Objective</h3><p>The systematic review and meta-analysis aimed to assess and compare the safety and efficacy of teriparatide vs. bisphosphonates and denosumab vs. bisphosphonates in patients with osteoporosis who had not previously received bisphosphonates.</p><h3>Methods</h3><p>We conducted a search of published literature from inception to May 31, 2023, including databases such as PubMed, Embase, Cochrane Library, CNKI, SinoMed, VIP, and WanFang. The study only included head-to-head randomized controlled trials (RCTs) that compared teriparatide and denosumab with bisphosphonates to treat patients with osteoporosis. Fixed-effect model and random-effect model were used due to clinical heterogeneity. Meta-analysis was performed via Stata 17.0.</p><h3>Results</h3><p>A total of 6680 patients were enrolled across 23 eligible trials. The results of the meta-analysis showed that teriparatide was superior to bisphosphonates in decreasing the risk of fracture (risk ratio (RR) = 0.61, 95% confidence interval (CI) (0.51, 0.74), <i>P</i> &lt; 0.001). Denosumab showed no benefit compared to bisphosphonates in reducing the risk of fracture in treating osteoporosis (RR 0.99, 95% CI (0.62, 1.57), <i>P</i> = 0.96). Compared with bisphosphonates, teriparatide and denosumab could significantly improve femoral neck, total hip, and lumbar spine bone mineral density (BMD) (<i>P</i> &lt; 0.05). Furthermore, teriparatide and denosumab did not increase the incidence of adverse events (teriparatide vs. bisphosphonates, RR 0.92, 95% CI (0.79, 1.08), <i>P</i> = 0.32; denosumab vs. bisphosphonates, RR 0.98, 95% CI (0.95, 1.02), <i>P</i> = 0.37).</p><h3>Conclusions</h3><p>Teriparatide is superior to bisphosphonates in decreasing the risk of fracture in patients with osteoporosis. In addition, teriparatide and denosumab were more efficacious than bisphosphonates in increasing the percentage change in BMD at the femoral neck, total hip, and lumbar spine.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bone Health Optimization Framework for Malaysia: a position paper by the Malaysian Bone Health Optimization Network (MyBONe)","authors":"Joon-Kiong Lee,&nbsp;Juzaily Fekry Leong,&nbsp;Fu-Yuen Thong,&nbsp;Mohd Ariff Sharifudin,&nbsp;Azlina Amir Abbas,&nbsp;Nur Azree Ferdaus Kamudin,&nbsp;Sanjiv Rampal,&nbsp;Nor Faissal Yasin,&nbsp;Kwong-Weng Loh,&nbsp;Chee-Ken Chan,&nbsp;Paul James Mitchell","doi":"10.1007/s11657-024-01448-6","DOIUrl":"10.1007/s11657-024-01448-6","url":null,"abstract":"<div><h3>Summary</h3><p>This position paper aims to establish and standardise Bone Health Optimization (BHO) strategies for older patients undergoing elective orthopaedic surgeries in Malaysia. It emphasises pre-, intra-, and post-operative assessments and tailored management. Adopting the “5IQ” approach, it proposes clinical standards and a registry to improve surgical outcomes and patient care.</p><h3>Purpose</h3><p>Osteoporosis and osteopenia are highly prevalent among older patients scheduled for elective arthroplasties and spinal surgeries. This position paper aims to establish, promote, and standardise effective Bone Health Optimization (BHO) strategies for such patients within orthopaedic practices in Malaysia. It emphasises the need for bone health assessments to be undertaken at the pre-operative, intra-operative, and post-operative stages, with tailored management strategies to meet individual patient needs.</p><h3>Methodology</h3><p>A comprehensive literature review was conducted, focusing on articles published from 2019 to 2024. Twelve broad themes were defined including definitions and importance of BHO, epidemiological data, assessment techniques, risk stratification, management strategies, and outcome metrics.</p><h3>Results</h3><p>Elective surgeries on patients with poor bone health are associated with adverse outcomes, such as periprosthetic fractures, aseptic loosening of implants, and complications after spinal surgeries. This position paper advocates for routine bone health assessments and monitoring during the pre-operative, intra-operative, and post-operative phases. It provides summaries of imaging modalities, risk assessment tools, and techniques for each phase. By adapting the successful “5IQ” approach from secondary fracture prevention, we propose 5IQ-based Clinical Standards for BHO, including 18 Key Performance Indicators. A Malaysian BHO Registry is proposed to benchmark care in real-time and support a national quality improvement programme. Practical resources, such as a BHO algorithm and key practice points, are included.</p><h3>Conclusion</h3><p>This position paper proposes a paradigm shift in the management of bone health for patients undergoing elective orthopaedic surgery in Malaysia, aiming to improve surgical outcomes and patient care through standardised BHO strategies.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01448-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subject-level spinal osteoporotic fracture prediction combining deep learning vertebral outputs and limited demographic data","authors":"Nathan M. Cross,&nbsp;Jessica Perry,&nbsp;Qifei Dong,&nbsp;Gang Luo,&nbsp;Jonathan Renslo,&nbsp;Brian C. Chang,&nbsp;Nancy E. Lane,&nbsp;Lynn Marshall,&nbsp;Sandra K. Johnston,&nbsp;David R. Haynor,&nbsp;Jeffrey G. Jarvik,&nbsp;Patrick J. Heagerty","doi":"10.1007/s11657-024-01433-z","DOIUrl":"10.1007/s11657-024-01433-z","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Automated screening for vertebral fractures could improve outcomes. We achieved an AUC-ROC = 0.968 for the prediction of moderate to severe fracture using a GAM with age and three maximal vertebral body scores of fracture from a convolutional neural network. Maximal fracture scores resulted in a performant model for subject-level fracture prediction. Combining individual deep learning vertebral body fracture scores and demographic covariates for subject-level classification of osteoporotic fracture achieved excellent performance (AUC-ROC of 0.968) on a large dataset of radiographs with basic demographic data.</p><h3>Purpose</h3><p>Osteoporotic vertebral fractures are common and morbid. Automated opportunistic screening for incidental vertebral fractures from radiographs, the highest volume imaging modality, could improve osteoporosis detection and management. We consider how to form patient-level fracture predictions and summarization to guide management, using our previously developed vertebral fracture classifier on segmented radiographs from a prospective cohort study of US men (MrOS). We compare the performance of logistic regression (LR) and generalized additive models (GAM) with combinations of individual vertebral scores and basic demographic covariates.</p><h3>Methods</h3><p>Subject-level LR and GAM models were created retrospectively using all fracture predictions or summary variables such as order statistics, adjacent vertebral interactions, and demographic covariates (age, race/ethnicity). The classifier outputs for 8663 vertebrae from 1176 thoracic and lumbar radiographs in 669 subjects were divided by subject to perform stratified fivefold cross-validation. Models were assessed using multiple metrics, including receiver operating characteristic (ROC) and precision-recall (PR) curves.</p><h3>Results</h3><p>The best model (AUC-ROC = 0.968) was a GAM using the top three maximum vertebral fracture scores and age. Using top-ranked scores only, rather than all vertebral scores, improved performance for both model classes. Adding age, but not ethnicity, to the GAMs improved performance slightly.</p><h3>Conclusion</h3><p>Maximal vertebral fracture scores resulted in the highest-performing models. While combining multiple vertebral body predictions risks decreasing specificity, our results demonstrate that subject-level models maintain good predictive performance. Thresholding strategies can be used to control sensitivity and specificity as clinically appropriate.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment reclassification in Canada from the Osteoporosis Canada 2023 clinical practice guidelines: the Manitoba BMD Registry","authors":"William D. Leslie,&nbsp;Lisa M. Lix,&nbsp;Neil Binkley","doi":"10.1007/s11657-024-01445-9","DOIUrl":"10.1007/s11657-024-01445-9","url":null,"abstract":"<div><h3>Summary</h3><p>Osteoporosis Canada 2023 clinical practice guidelines increase the number of individuals recommended or suggested for anti-osteoporosis pharmacotherapy by refining treatment guidance for those who fell within the 2010 guidelines’ moderate-risk category.</p><h3>Purpose</h3><p>In 2023, Osteoporosis Canada updated its 2010 clinical practice guidelines based upon consideration of fracture history, 10-year major osteoporotic fracture (MOF) risk, and BMD <i>T</i>-score in conjunction with age. The 2023 guidelines eliminated risk categories, including the moderate-risk group that did not provide clear treatment guidance. The current study was performed to appreciate the implications of the shift from 2010 risk categories to 2023 treatment guidance.</p><h3>Methods</h3><p>The study population consisted of 79,654 individuals age ≥ 50 years undergoing baseline DXA testing from January 1996 to March 2018. Each individual was assigned to mutually exclusive categories based on 2010 and 2023 guideline recommendations. Treatment qualification, 10-year predicted and 10-year observed MOF risk were compared.</p><h3>Results</h3><p>Treatment reclassification under the 2023 guidelines only affected 33.8% of individuals in the 2010 moderate-risk group, with 13.0% assigned to no treatment, 14.4% to suggest treatment, and 6.4% to recommend treatment. During the mean follow-up of 7.2 years, 6364 (8.0%) individuals experienced one or more incidents of MOF. The observed 10-year cumulative incidence of MOF in the study population was 10.5% versus the predicted 10.7% (observed to predicted mean calibration ratio 0.98, 95% CI 0.96–1.00). Individuals reclassified from 2010 moderate risk to 2023 recommend treatment were at greater MOF risk than those in the 2010 moderate-risk group assigned to 2023 suggest treatment or no treatment, but at lower risk than those in the 2010 high-risk group.</p><h3>Conclusions</h3><p>Osteoporosis Canada 2023 clinical practice guidelines affect individuals within the 2010 moderate-risk category, increasing the number for whom anti-osteoporosis pharmacotherapy is recommended or suggested. Increased treatment could reduce the population burden of osteoporotic fractures, though moderate-risk individuals now qualifying for treatment have a lower predicted and observed fracture risk than high-risk individuals recommended for treatment under the 2010 guidelines.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of minimum common data set in the development of the Greek Fragility Hip Fracture Registry in the Greek health care setting: the first year of its pilot implementation","authors":"Efthymios Iliopoulos,&nbsp;Theodoros Tosounidis,&nbsp;Reichan Molla Moustafa,&nbsp;Fotios Tilkidis,&nbsp;Ioannis Daskalakis,&nbsp;Dimitra Melissaridou,&nbsp;Dimitrios Serenidis,&nbsp;Vasileios Giannatos,&nbsp;Maria Sentona,&nbsp;Dimitrios Grammatikopoulos,&nbsp;Ioannis Gkiatas,&nbsp;Irini Tatani,&nbsp;Christianna Zidrou,&nbsp;Olga Savvidou,&nbsp;Michael Potoupnis,&nbsp;Georgios Drosos","doi":"10.1007/s11657-024-01443-x","DOIUrl":"10.1007/s11657-024-01443-x","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;\u0000 &lt;i&gt;Summary&lt;/i&gt;\u0000 &lt;/h3&gt;&lt;p&gt;The first Fragility Hip Fracture Registry has been established in Greece. The in-hospital length of stay was 10.8 days and was significantly influenced by the delayed surgical fixation. The increased age, the higher ASA grade, and the male gender influenced negatively the 30-day mortality, which reached 7.5%.&lt;/p&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The increased incidence of fragility hip fractures constitutes a great challenge to the health care professionals and causes a significant burden on national health care systems around the globe. Fragility hip fracture registries have been used in many countries in order to document the cotemporary situation in each country and to identify potential weaknesses of the local health care systems.&lt;/p&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;p&gt;The aim of the herein study is to present the results of the pilot implementation of the first fragility hip fracture registry in Greece, which was developed by the Greek Chapter of Fragility Fracture Network (FFN Gr), and use the neural networks in the analysis of the results.&lt;/p&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;p&gt;Seven orthopaedic departments from six different hospitals in Greece participated in the present pilot study. All fragility hip fractures from September 2022 until December 2023 were prospectively collected and documented using a central database. For this purpose, the 22 points of minimum common data set, proposed by the Global Fragility Fracture Network, with the addition of the 30-day mortality was used.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;A total of 1009 patients who sustained a fragility hip fracture were included in the study. The mean age of the cohort was 82.2 ± 8.6 years with the majority of patients being female (72%). Sixty percent (60%) of the patients had an extracapsular hip fracture, with a mean ASA grade 2.6 ± 0.8. Intramedullary nailing and hip hemiarthroplasty were the surgical treatments of choice in the majority of extra- and intra-capsular hip fractures respectively. The mean hospital length of stay of the patients was 10.8 ± 8.5 days, and the 30-day mortality was 7.5%. The multivariant analysis revealed that the age, the ASA grade and the male gender had a significant contribution to the 30-day mortality. The neural network model had a significant under-the-curve predictive value (0.778), with age being the most important predictive factor. The length of stay was significantly influenced only by the delayed surgical fixation (more than 36 h from admission).&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;The present pilot study provides evidence that establishing a fragility hip fracture registry in Greece is feasible and demonstrates that the minimum common data set can be used as the base of any new registry. In Greece, patients with a fragility hip fracture stay in the hospital for approximately 11 days and have 7.5% 30-day mortality. Unfortunately, due to the logistics of the public healthcare system, they do not receive surgica","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similarities and differences between European guidelines for the management of postmenopausal osteoporosis","authors":"Bernard Cortet,&nbsp;Núria Guañabens,&nbsp;Maria Luisa Brandi,&nbsp;Heide Siggelkow","doi":"10.1007/s11657-024-01441-z","DOIUrl":"10.1007/s11657-024-01441-z","url":null,"abstract":"<p>We conducted a review of 10 national guidelines from five EU countries to identify similarities or differences in recommendations for the management of patients with osteoporosis. We found general alignment of key recommendations; however, there are notable differences, largely attributed to country-specific approaches to risk assessment and reimbursement conditions.</p><p>The classification of fracture risk is critical for informing treatment decisions for post-menopausal osteoporosis. The aim of this review was to summarise 10 national guidelines from five European countries, with a focus on identifying similarities or differences in recommendations for the management of patients with osteoporosis.</p><p>We summarised the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Disease-International Osteoporosis Foundation guidelines and reviewed guidelines from France, Germany, Italy, Spain and the UK.</p><p>The approach to risk assessment differed across the guidelines. In France, and Spain, risk assessment was based on DXA scans and presence of prior fractures, whereas UK, German and Italian guidelines recommended use of a validated risk tool. These differences led to distinct definitions of very high and high-risk patients. Guidelines aligned in recommending antiresorptive and anabolic agents as pharmacologic options for the management of osteoporosis, with sequential treatment recommended. There was agreement that patients at high or very high risk of fracture or with severe osteoporosis should receive anabolic agents first, followed by antiresorptive drugs. Variations were identified in recommendations for follow up of patients on anti-osteoporosis therapies. Reimbursement conditions in each country were a key difference identified.</p><p>Criteria for risk assessment of fractures differ across European guidelines which may impact treatment and access to anabolic agents. Harmonisation across EU guidelines may help identify patients eligible for treatment and impact treatment uptake. However, country-specific reimbursement and prescribing processes may present a challenge to achieving a consistent approach across Europe.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of osteoporosis among older Asian men with type-2 diabetes mellitus, hypertension, or hyperlipidaemia","authors":"Yu Quan Tan,&nbsp;Ding Xuan Ng,&nbsp;Kalaipriya Gunasekaran,&nbsp;Weai Ling Lim,&nbsp;Ngiap Chuan Tan","doi":"10.1007/s11657-024-01442-y","DOIUrl":"10.1007/s11657-024-01442-y","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>This study investigated osteoporosis risk factors among older Asian men with type-2 diabetes mellitus, hypertension, or hyperlipidaemia in primary care. Advanced age, dementia, depression, and polypharmacy were associated with higher risks for osteoporosis. Screening strategies targeting these factors are crucial for improving bone health as part of comprehensive preventive care.</p><h3>Purpose</h3><p>Asian patients with type-2 diabetes mellitus (T2DM), hypertension, or hyperlipidaemia (DHL) are predominantly managed in primary care. They are also at risk of osteoporosis, but men are often under-screened and under-treated for this preventable bone disorder. This study aimed to identify the clinical characteristics and risk factors of osteoporosis among older men with DHL in primary care for early intervention.</p><h3>Methods</h3><p>This retrospective study included men aged 65 years and older managed in public primary care clinics for their DHL between 1st July 2017 and 30th June 2018. Demographic, clinical, laboratory, and imaging data were extracted from their electronic medical records based on their International Classification of Diseases-10 (ICD-10) diagnosis codes. Descriptive statistical analyses, with statistical significance set at <i>p</i> &lt; 0.05, were conducted, followed by generalized estimating equation (GEE) modelling.</p><h3>Results</h3><p>Medical records of 17,644 men (83.1% Chinese, 16.9% minority ethnic groups, median age 71 years) were analysed. 2.3% of them had diagnosis of osteoporosis, 0.15% had fragility fracture, and 26.0% of those diagnosed with osteoporosis were treated with bisphosphonates. Their mean HbA1c was 6.9%; mean systolic and diastolic blood pressure were 133 and 69 mmHg. The GEE model showed that age (OR = 1.07, 95%CI = 1.05–1.09, <i>p</i> &lt; 0.001), dementia (OR = 2.24, 95%CI = 1.33–3.77, <i>p</i> = 0.002), depression (OR = 2.38, 95%CI = 1.03–5.50, <i>p</i> = 0.043), and polypharmacy (OR = 6.85, 95%CI = 3.07–15.26, <i>p</i> &lt; 0.001) were significantly associated with higher risks for osteoporosis.</p><h3>Conclusion</h3><p>Age, dementia, depression, and polypharmacy are associated with osteoporosis risks in men with DHL. Strategies to incorporate osteoporosis screening among older men with these risk factors are needed to improve their bone health.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}