Make or break time for osteoporosis treatment

Women who do not comply with treatment instructions for osteoporosis or who do not respond to treatment are more likely to suffer further fractures, which seriously affects their quality of life.

There is an urgent need to provide support to these patients and address their issues when new therapies are assessed and new treatment guidelines drawn up, according to lead researcher Professor Cyrus Cooper from the MRC Epidemiology Resource Centre, University of Southampton, in the UK. His findings will be published in the April issue of Osteoporosis International, a Springer journal.

Osteoporosis is an increasing global health problem and currently available therapies have been shown to reduce the risk of fragility fractures in postmenopausal women. Most patients gain bone mineral density within a year of treatment. However, surveys of osteoporotic patients show that compliance to treatment is low in practice, and up to 50% of patients stop their treatment within a year due in part to side-effects. In addition, clinical trials show that osteoporotic fractures have physical, psychological and social implications that can seriously affect patients’ quality of life.

Cooper and colleagues’ study, the Observational Study of Severe Osteoporosis (OSSO)*, looked at the number of fractures suffered by women who did not respond to drug therapy, and how treatment failure affected their health-related quality of life. A total of 1,885 70-year-old women with established osteoporosis and ‘inadequate clinical response to osteoporosis drug therapy’ were assessed over a year. The researchers used a combination of two questionnaires to measure their quality of life at the start of the study, and then after six months and after a year. ‘Inadequate clinical response to osteoporosis drug therapy’ is defined as either a fragility fracture despite therapy for one year, or discontinued drug treatment due to adverse effects and/or noncompliance.

A total of 209 fractures occurred in 166 women over the year. Women who had suffered fractures in the past were more likely to sustain a new fracture than those who had not. Quality of life scores were worse in women who suffered a fracture regardless of whether they had had a fracture in the past. General health perception, social function and pain were the worst rated quality of life measures.

These findings show that the risk of fracture is high in women after failed osteoporosis therapy and the presence of a previous fracture in the previous 12 months strongly predicts a fracture in the next 12 months. The improvement in quality of life in the absence of fractures was significant, indicating the need for effective treatments for patients with osteoporosis.

Source: Springer

Related stories:

Adult stem cells improve fracture healing
In an approach that could become a new treatment for the 10 to 20 percent of people whose broken bones fail to heal, researchers at the University of North Carolina at Chapel Hill have shown that transplantation of adult stem cells can improve healing of fractures.
Study shows that prostate cancer increases the risk of bone fracture
As unlikely as it sounds, scientists at the Garvan Institute for Medical Research have shown that there is a link between prostate cancer and a higher risk of bone fracture.
Osteoporosis drug may be associated with irregular heartbeat
Alendronate, a medication used to prevent fractures in women with osteoporosis, may be associated with an increased risk of atrial fibrillation, a type of abnormal heart rhythm, according to a report in the April 28 issue of Archives of Internal Medicine.
Osteoporosis drug fosamax linked to heart problem
Women who have used Fosamax are nearly twice as likely to develop the most common kind of chronically irregular heartbeat (atrial fibrillation) than are those who have never used it, according to research from Group Health and the University of Washington published in the April 28 Archives of Internal Medicine.
Minimally Invasive Technique May Offer Quick and Safe Pain Relief in Osteoporosis Patients with Low Back Pain
An X-ray guided injection of synthetic bone cement into fractured pelvic bones may provide rapid and safe pain relief to osteoporosis patients with low back pain, according to a new multicenter pilot study.
Value of drugs for pre-osteoporosis exaggerated
A series of recent scientific publications have exaggerated the benefits and underplayed the harms of drugs to treat pre-osteoporosis or “osteopenia” potentially encouraging treatment in millions of low risk women, warn experts in this week’s BMJ.
A single bone mineral density test predicts 'silent' spinal fractures years later
A single bone mineral density (BMD) test given 15 years earlier predicted a woman’s risk of developing fractures to her spine over time, according to the largest and longest prospective study of osteoporosis.
Engineers developing new cements to heal spinal fractures
New research could offer hope for victims of the most devastating spinal injuries - typically those caused in car crashes.

News discussion:

Medicine & Health news