Amgen announced new data presented from a cross-sectional study revealing a gap in the diagnosis and treatment of osteoporosis in Europe. The real-world study of osteoporosis management in primary care revealed that 75 percent of female patients aged 70 years and older who were at increased risk of fragility fractures were not treated for osteoporosis. The treatment gap was much lower in those with a recorded diagnosis of osteoporosis than in those without a recorded diagnosis. The results of the study, which was performed across eight European countries, were presented during the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO), in Paris from April 4-7, 2019.
"This study assessed patterns of real-world osteoporosis diagnosis and medical treatment in the European primary care setting," said Eugene McCloskey, M.D., FRCPI, Professor of Adult Bone Diseases at The University of Sheffield and Director of the MRC Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing. "Based on the results, future strategies need to increase awareness and facilitate the diagnosis of patients at risk in order to improve the treatment of osteoporosis and prevent fragility fractures from happening."
The study enrolled 3,798 women aged 70 years or older after spontaneously visiting their primary care physician for any reason, not specifically related to their bone health. The primary outcome of the study was to assess the proportion of patients at increased risk of fragility fracture who were not receiving osteoporosis medication. Nearly 55 percent (n=2,077/3,798) of patients were considered to be at increased risk of fragility fracture, with 75 percent (n=1,550/2,077) of them not being medically treated for osteoporosis. Further, the study showed that among these untreated patients at risk for fracture, 85 percent (n=1,318/1,550) had no recorded diagnosis of osteoporosis.
"This real-world study further proves that an underdiagnosis of osteoporosis in Europe is a major barrier to treatment," said David M. Reese, M.D., executive vice president of Research and Development at Amgen. "The finding that the vast majority of patients at increased risk of fracture remain untreated underscores the drastic need for better osteoporosis management and reinforces our ongoing commitment to help address this worldwide public health crisis and improve the care for millions of people living with this disease."
About the Study
This cross-sectional study was conducted across eight European countries (Belgium, France, Germany, Ireland, Poland, Slovakia, Switzerland and the United Kingdom). The study included 3,798 community-dwelling women aged 70 years or older (median age 77 years) spontaneously visiting their primary care physician mainly for existing conditions (follow up for known disease 52.1 per cent, medication refill 20.6 percent, new symptoms 21.7 per cent).
Patient demographics, treatment history and clinical risk factors were collected via self-reported questionnaires and medical records. The primary objective was to assess the proportion of women at increased risk of fragility fracture and not receiving osteoporosis medication. Increased risk of fragility fracture was defined as at least one of (1) history of previous fractures after age 50, (2) FRAX®-score (10-year probability of hip and major osteoporotic fracture above country-specific FRAX thresholds), (3) bone densitometry (DXA) results (bone mineral density T-score of -2.5 or less).
Prevalence of FRAX risk factors ranged from 32 per cent (prior fracture) to 1 per cent (alcohol 3 or more units/day). 2,077 women (55 per cent, median age 80 years) were determined to be at increased fracture risk, but only 31 per cent of these had a recorded diagnosis of osteoporosis. For the primary outcome, 75 per cent (95 percent CI: 72.7-76.5 per cent) of women at increased risk of fragility fracture were not receiving any osteoporosis medication; this treatment gap was much lower in those with a recorded diagnosis of osteoporosis than in those without a recorded diagnosis. A small proportion of patients who did not meet the study definition of increased risk for fragility fracture had a previous diagnosis of osteoporosis (10 percent).
Osteoporosis affects many women after menopause as their ability to form new bone cannot counter balance the rate at which bone is being removed. This bone loss leads to weakened bones over time, increasing the potential for a break.
It is estimated that one in three women over the age of 50 will experience an osteoporotic fracture in her remaining lifetime. Patients who experience an osteoporosis-related fracture are twice as likely to experience a future fracture.
The World Health Organisation has officially declared osteoporosis a public health crisis, and the International Osteoporosis Foundation urges governments worldwide to make osteoporosis a healthcare priority.
This release was first published 7 April 2019 by Amgen.