Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting
Identifieur interne : 000A40 ( Main/Merge ); précédent : 000A39; suivant : 000A41Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting
Auteurs : J. A. Kanis [Australie] ; C. Cooper [Royaume-Uni] ; R. Rizzoli [Suisse] ; B. Abrahamsen [Danemark] ; N. M. Al-Daghri [Arabie saoudite] ; M. L. Brandi [Italie] ; J. Cannata-Andia [Espagne] ; B. Cortet [France] ; H. P. Dimai [Autriche] ; S. Ferrari [Suisse] ; P. Hadji [Allemagne] ; N. C. Harvey [Royaume-Uni] ; M. Kraenzlin [Suisse] ; A. Kurth [Allemagne] ; E. Mccloskey [Royaume-Uni] ; S. Minisola [Italie] ; T. Thomas [France] ; J.-Y. Reginster [Belgique]Source :
- Osteoporosis International [ 0937-941X ] ; 2017.
Abstract
Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target appropriate treatment more precisely and cost-effectively, and should be the focus of future research.
The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture.
A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review current data on the epidemiology and burden of osteoporosis and the patterns of medical management throughout Europe.
In Europe in 2010, the cost of managing osteoporosis was estimated at €37 billion and notably the costs of treatment and long-term care of patients with fractures were considerably higher than the costs for pharmacological prevention. Despite the availability of effective treatments, the uptake of osteoporosis therapy is low and declining, in particular for secondary fracture prevention where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced.
Implementation of global fracture prevention strategies is a critical need. Future research should focus on identifying specific risk factors for imminent fractures, periods of high fracture risk, patients who are at increased risk of fracture and therapies that are most suited to such high-risk patients and optimal implementation strategies in primary, secondary and tertiary care.
Url:
DOI: 10.1007/s00198-017-4009-0
PubMed: 28451733
PubMed Central: 5483332
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<affiliation wicri:level="1"><nlm:aff id="Aff9">Bone and Mineral Research Unit, Instituto “Reina Sofía” de Investigación, REDinREN ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Asturias, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Bone and Mineral Research Unit, Instituto “Reina Sofía” de Investigación, REDinREN ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Asturias</wicri:regionArea>
<wicri:noRegion>Asturias</wicri:noRegion>
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</author>
<author><name sortKey="Cortet, B" sort="Cortet, B" uniqKey="Cortet B" first="B." last="Cortet">B. Cortet</name>
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<institution-id institution-id-type="GRID">grid.410463.4</institution-id>
<institution>Department of Rheumatology,</institution>
<institution>Lille University Hospital,</institution>
</institution-wrap>
Lille, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Lille</wicri:regionArea>
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</author>
<author><name sortKey="Dimai, H P" sort="Dimai, H P" uniqKey="Dimai H" first="H. P." last="Dimai">H. P. Dimai</name>
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<institution-id institution-id-type="GRID">grid.11598.34</institution-id>
<institution>Department of Internal Medicine, Division of Endocrinology and Diabetology,</institution>
<institution>Medical University of Graz,</institution>
</institution-wrap>
Graz, Austria</nlm:aff>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Graz</wicri:regionArea>
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<author><name sortKey="Ferrari, S" sort="Ferrari, S" uniqKey="Ferrari S" first="S." last="Ferrari">S. Ferrari</name>
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<institution-id institution-id-type="GRID">grid.150338.c</institution-id>
<institution>Service of Bone Diseases,</institution>
<institution>Geneva University Hospitals and Faculty of Medicine,</institution>
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Geneva, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Geneva</wicri:regionArea>
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<author><name sortKey="Hadji, P" sort="Hadji, P" uniqKey="Hadji P" first="P." last="Hadji">P. Hadji</name>
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<institution-id institution-id-type="GRID">grid.468184.7</institution-id>
<institution>Department of Bone Oncology, Endocrinology and Reproductive Medicine,</institution>
<institution>Krankenhaus Nordwest,</institution>
</institution-wrap>
Frankfurt, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Frankfurt</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Harvey, N C" sort="Harvey, N C" uniqKey="Harvey N" first="N. C." last="Harvey">N. C. Harvey</name>
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<institution-id institution-id-type="GRID">grid.5491.9</institution-id>
<institution>MRC Lifecourse Epidemiology Unit,</institution>
<institution>University of Southampton,</institution>
</institution-wrap>
Southampton, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Southampton</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kraenzlin, M" sort="Kraenzlin, M" uniqKey="Kraenzlin M" first="M." last="Kraenzlin">M. Kraenzlin</name>
<affiliation wicri:level="1"><nlm:aff id="Aff13">Endonet, Endocrine Clinic and Laboratory, Basel, Switzerland</nlm:aff>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Endonet, Endocrine Clinic and Laboratory, Basel</wicri:regionArea>
<wicri:noRegion>Basel</wicri:noRegion>
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</author>
<author><name sortKey="Kurth, A" sort="Kurth, A" uniqKey="Kurth A" first="A." last="Kurth">A. Kurth</name>
<affiliation wicri:level="3"><nlm:aff id="Aff14">Department of Orthopaedic Surgery and Osteology, Klinikum Frankfurt, Frankfurt, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Orthopaedic Surgery and Osteology, Klinikum Frankfurt, Frankfurt</wicri:regionArea>
<placeName><region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Darmstadt</region>
<settlement type="city">Francfort-sur-le-Main</settlement>
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</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff15"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9116 4836</institution-id>
<institution-id institution-id-type="GRID">grid.14095.39</institution-id>
<institution>Mayor Teaching Hospital,</institution>
<institution>Charitè Medical School,</institution>
</institution-wrap>
Berlin, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Berlin</wicri:regionArea>
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</author>
<author><name sortKey="Mccloskey, E" sort="Mccloskey, E" uniqKey="Mccloskey E" first="E." last="Mccloskey">E. Mccloskey</name>
<affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9262</institution-id>
<institution-id institution-id-type="GRID">grid.11835.3e</institution-id>
<institution>Centre for Metabolic Bone Diseases,</institution>
<institution>University of Sheffield Medical School,</institution>
</institution-wrap>
Beech Hill Road, Sheffield, S10 2RX UK</nlm:aff>
<wicri:noCountry code="subfield">S10 2RX UK</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 9262</institution-id>
<institution-id institution-id-type="GRID">grid.11835.3e</institution-id>
<institution>MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research,</institution>
<institution>University of Sheffield,</institution>
</institution-wrap>
Sheffield, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Sheffield</wicri:regionArea>
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</author>
<author><name sortKey="Minisola, S" sort="Minisola, S" uniqKey="Minisola S" first="S." last="Minisola">S. Minisola</name>
<affiliation wicri:level="1"><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="GRID">grid.7841.a</institution-id>
<institution>Department of Internal Medicine and Medical Disciplines,</institution>
<institution>“Sapienza” Università di Roma,</institution>
</institution-wrap>
Rome, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Rome</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thomas, T" sort="Thomas, T" uniqKey="Thomas T" first="T." last="Thomas">T. Thomas</name>
<affiliation wicri:level="1"><nlm:aff id="Aff18"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1765 1491</institution-id>
<institution-id institution-id-type="GRID">grid.412954.f</institution-id>
<institution>INSERM U1059, Laboratoire Biologie Intégrée du Tissu Osseux, Rheumatology Department,</institution>
<institution>CHU Saint-Etienne, Université de Lyon,</institution>
</institution-wrap>
Saint-Etienne, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Saint-Etienne</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Reginster, J Y" sort="Reginster, J Y" uniqKey="Reginster J" first="J.-Y." last="Reginster">J.-Y. Reginster</name>
<affiliation wicri:level="1"><nlm:aff id="Aff19"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0805 7253</institution-id>
<institution-id institution-id-type="GRID">grid.4861.b</institution-id>
<institution>Department of Public Health, Epidemiology and Health Economics,</institution>
<institution>University of Liège,</institution>
</institution-wrap>
Liège, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Liège</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Osteoporosis International</title>
<idno type="ISSN">0937-941X</idno>
<idno type="eISSN">1433-2965</idno>
<imprint><date when="2017">2017</date>
</imprint>
</series>
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</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Summary</title>
<p id="Par1">Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target appropriate treatment more precisely and cost-effectively, and should be the focus of future research.</p>
</sec>
<sec><title>Introduction</title>
<p id="Par2">The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture.</p>
</sec>
<sec><title>Methods</title>
<p id="Par3">A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review current data on the epidemiology and burden of osteoporosis and the patterns of medical management throughout Europe.</p>
</sec>
<sec><title>Results</title>
<p id="Par4">In Europe in 2010, the cost of managing osteoporosis was estimated at €37 billion and notably the costs of treatment and long-term care of patients with fractures were considerably higher than the costs for pharmacological prevention. Despite the availability of effective treatments, the uptake of osteoporosis therapy is low and declining, in particular for secondary fracture prevention where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced.</p>
</sec>
<sec><title>Conclusions</title>
<p id="Par5">Implementation of global fracture prevention strategies is a critical need. Future research should focus on identifying specific risk factors for imminent fractures, periods of high fracture risk, patients who are at increased risk of fracture and therapies that are most suited to such high-risk patients and optimal implementation strategies in primary, secondary and tertiary care.</p>
</sec>
</div>
</front>
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