March 3rd, 2021

// Identification and Management of Osteoporotic Fractures is Lacking, Putting Long-Term Health of Patients at Risk

Identification and Management of Osteoporotic Fractures is Lacking, Putting Long-Term Health of Patients at Risk

80-90% of Canadian adults do not receive appropriate osteoporosis 
management even after they break a bone due to osteoporosis

MISSISSAUGA, ON, March 2, 2021 /CNW/ - Fractures due to osteoporosis, a skeletal disorder characterized by low bone mineral density1, have been labelled a public health crisis.2 This is in part due to an increasing number of older adults at risk of fractures due to osteoporosis (known as fragility fractures) as well as the low rates of osteoporosis management in patients who experience a fragility fracture across Europe and North America.3

Real-world evidence published in two recent Canadian studies illustrates the critical importance of recognizing and treating fractures caused by osteoporosis, as they can mean imminent risk for subsequent breaks and even death. 4,5 This Canadian data further supports recently published global calls to action urging for a shift in focus to managing osteoporosis in adults who experience a fragility fracture.6

"Our research demonstrates that, particularly over the age of 65, a fragility fracture anywhere in the body can significantly increase the risk of subsequent fractures and as much as double the risk of death in the first year after fracture," said Dr. Jacques P. Brown, Professeur de Clinique en Rhumatologie, Université Laval, an author on both studies. We need to pay close attention to these risk factors, closely monitor those who experience an osteoporosis-related break and provide education related to fracture and mortality risk to better manage this condition." 

About the Studies

Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canadawas conducted with Canadians older than 65 and concluded that those who experienced a fragility fracture are at imminent risk of experiencing a subsequent fracture within the next two years and should be proactively assessed and treated.

This study identified Canadians older than 65 with an initial fragility fracture occurring between 2011 and 2015. Among the 115,776 patients with a fragility fracture, 18% experienced another fragility fracture on average within two years after the initial fracture. The most common sites of the initial fracture were the hip (27%) and wrist (15%). 

Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario8was also conducted with Canadians older than 65 and confirmed that a fragility fracture is associated with increased mortality risk. In fact, survival declined over the six years following the fracture with the steepest decline occurring within the first year, when mortality risk more than doubled and deaths were observed in one in eight women and one in five men with fractures. 

In spite of this increased mortality after fracture, a large care gap persists for the prevention of fractures. Studies show that an estimated 80–90% of adults do not receive appropriate osteoporosis management, even after they experience a fracture due to osteoporosis.9 In contrast, in Canada, approximately 90% of patients with cardiovascular risk factors receive appropriate disease management to prevent a subsequent cardiovascular event.10

Both the Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada and Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario studies were supported financially by Amgen Canada.

About Osteoporosis

Osteoporosis is a condition that causes bones to become thin and porous, decreasing bone strength and leading to increased risk of breaking a bone.11 The most common sites of broken bones from osteoporosis are the wrist, spine, shoulder and hip.13 Osteoporosis can strike at any age, however it mainly affects women after menopause as their ability to form new bone cannot keep up with the rate at which bone is being lost.13,12 This bone loss leads to weakened bones over time, increasing the potential for a break.13

At least one in three women and one in five men will suffer a broken bone from osteoporosis during their lifetime.13 Broken bones from osteoporosis are more common than heart attack, stroke and breast cancer combined.2 One in three people who break a hip will re-break it at one year, and over one in two will suffer another bone break within five years.13

The World Health Organization has officially declared osteoporosis a public health crisis13, while the International Osteoporosis Foundation urges governments worldwide to make osteoporosis a healthcare priority.14

About Amgen Canada

As a leader in innovation, Amgen Canada understands the value of science. With main operations located in Mississauga, Ont.'s vibrant biomedical cluster, and its research facility in Burnaby, B.C., Amgen Canada has been an important contributor to advancements in science and innovation in Canada since 1991. The company contributes to the development of new therapies and new uses for existing medicines in partnership with many of Canada's leading health-care, academic, research, government and patient organizations. To learn more about Amgen Canada, visit www.amgen.ca.

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1 Public Health Agency of Canada (2009) Fast Facts from the 2009 Canadian Community Health Survey - Osteoporosis Rapid Response. https://www.canada.ca/en/public-health/services/chronic-diseases/osteoporosis/what-impact-osteoporosis-what-canadians-doing-maintain-healthy-bones.html. Accessed 25 September 2020
2 The World Health Organization. Bulletin of the World Health Organization. Exercise interventions: defusing the world's osteoporosis time bomb. Available at: http://www.who.int/bulletin/volumes/81/11/mingchanwa1103.pdf. Accessed April 2019.   
3 Roux C, Briot K. The crisis of inadequate treatment in osteoporosis. Lancet Rheumatol. 2020;2(2):E110-E9.
4 Jonathan D. Adachi, Jacques P. Brown, Emil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan D. Bell, Maureen Reiner, Millicent Packalen, Ponda Motsepe-Ditshego, Natasha Burke, Lubomira Slatkovska. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada.
5 Jacques P. BrownJonathan D. AdachiEmil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan Bell, Maureen Reiner, Thiago Oliveira, Ponda Motsepe-DitshegoNatasha Burke, Lubomira Slatkovska. Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario.
6 Binkley N, Blank RD, Leslie WD, Lewiecki EM, Eisman JA, Bilezikian JP. Osteoporosis in Crisis: It's Time to Focus on Fracture. J Bone Miner Res. 2017;32(7):1391-4.
Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019;393(10169):364-76.
Dreinhofer KE, Mitchell PJ, Begue T, Cooper C, Costa ML, Falaschi P, et al. A global call to action to improve the care of people with fragility fractures. Injury. 2018;49(8):1393-7.
Jonathan D. Adachi, Jacques P. Brown, Emil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan D. Bell, Maureen Reiner, Millicent Packalen, Ponda Motsepe-Ditshego, Natasha Burke, Lubomira Slatkovska. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada.
8 Jacques P. BrownJonathan D. AdachiEmil Schemitsch, Jean-Eric Tarride, Vivien Brown, Alan Bell, Maureen Reiner, Thiago Oliveira, Ponda Motsepe-DitshegoNatasha Burke, Lubomira Slatkovska. Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario.
9 Papaioannou A, Giangregorio L, Kvern B, Boulos P, Ioannidis G, Adachi JD. The osteoporosis care gap in Canada. BMC Musculoskelet Disord. 2004;5:11.
Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, et al. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int. 2008;19(1):79-86.
10 Bell A, Hill MD, Herman RJ, Girard M, Cohen E, Canadian RoAfCHRSC. Management of atherothrombotic risk factors in high-risk Canadian outpatients. Can J Cardiol. 2009;25(6):345-51.
11 Osteoporosis Canada. Osteoporosis Facts and Statistics. https://osteoporosis.ca/about-the-disease/fast-facts/ Accessed September 28, 2020. 
12 International Osteoporosis Foundation. The Global Burden of Osteoporosis: A Factsheet. Available at: https://iofbonehealth.org/sites/default/files/media/PDFs/Fact%20Sheets/2014-factsheet-osteoporosis-A4.pdf. Accessed September 28, 2020.
13 The World Health Organization. Bulletin of the World Health Organization. Exercise interventions: defusing the world's osteoporosis time bomb. Available at: http://www.who.int/bulletin/volumes/81/11/mingchanwa1103.pdf. Accessed September 28, 2020.
14 International Osteoporosis Foundation. Global Initiatives. Available at http://www.iofbonehealth.org/global-initiatives-0. Accessed September 28, 2020.

SOURCE Amgen Canada

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