One- and 2-year Incidence of Osteoporotic Fracture: a Multi-cohort Observational Study Using Routinely Collected Real-world Data

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2021 Aug 15

PMID 34392386

Citations 5

Authors

Sara Khalid

Carlen Reyes

Martin Ernst

Antonella Delmestri

Emese Toth

Cesar Libanati

Bo Abrahamsen

Daniel Prieto-Alhambra

Affiliations

Soon will be listed here.

Abstract

Purpose: To characterize and estimate 1- to 2-year fracture risk in high-risk fracture patients.

Methods: Multi-cohort study in (database/study period) UK (CPRD/1995-2017), Spain (SIDIAP/2006-2016) and Denmark (DHR/1995-2016) including individuals ≥ 50 years old in NDO (newly diagnosed osteoporosis), OFx (incident osteoporotic fracture), BP (incident oral bisphosphonates use) or FWOT (fracture while on treatment with bisphosphonates). Outcomes (ICD-10/READ): hip, clinical spine, non-hip, non-spine and hip/humerus/distal forearm fracture.

Follow-up: from cohort entry until death, migration/transfer or end of the study.

Statistics: baseline characteristics and incidence rate (IR per 1000 persons). RESULTS (1-YEAR IR): NDO included 69,899 (UK), 37,901 (Spain) and 158,191 (Denmark) individuals. Spanish-IR was lowest for hip (4.7), clinical spine (2.5) and major osteoporotic fracture (MOF) (17.3) and highest in Denmark (74.2, 26.0 and 120.1, respectively). OFx included 83,514 (UK), 51,044 (Spain) and 509,551 (Denmark) individuals. IR in Denmark was highest for hip (24.1) and MOF (47.2), in Spain was highest for the clinical spine (9.4) and lowest for hip (9.5) and in the UK was lowest for the clinical spine (2.8) and MOF (20.7). BP included 148,507 (UK), 52,037 (Spain) and 204,010 (Denmark) individuals. Spanish-IR was lowest for hip (5.0) and MOF (21.1) and highest in Denmark (20.3 and 48.6, respectively). FWOT included 28,930 (UK), 1,865 (Spain) and 31,882 (Denmark) individuals. Clinical spine-IR was highest for Spain (12.0). Hip-IR was lowest for Spain (7.6) and highest for Denmark (33.6). Comparing young subjects, those who have FWOT started with an increased fracture rate.

Conclusion: OFx and FWOT individuals experience higher re-fracture incidence rates than those with osteoporosis with or without treatment.

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References

Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J . Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations.... Arch Osteoporos. 2013; 8:136. PMC: 3880487. DOI: 10.1007/s11657-013-0136-1. View

Banefelt J, Akesson K, Spangeus A, Ljunggren O, Karlsson L, Strom O . Risk of imminent fracture following a previous fracture in a Swedish database study. Osteoporos Int. 2019; 30(3):601-609. PMC: 6422949. DOI: 10.1007/s00198-019-04852-8. View

Bonafede M, Shi N, Barron R, Li X, Crittenden D, Chandler D . Predicting imminent risk for fracture in patients aged 50 or older with osteoporosis using US claims data. Arch Osteoporos. 2016; 11(1):26. PMC: 4967418. DOI: 10.1007/s11657-016-0280-5. View

Balasubramanian A, Zhang J, Chen L, Wenkert D, Daigle S, Grauer A . Risk of subsequent fracture after prior fracture among older women. Osteoporos Int. 2018; 30(1):79-92. PMC: 6332293. DOI: 10.1007/s00198-018-4732-1. View

Kanis J, Johansson H, Oden A, Harvey N, Gudnason V, Sanders K . Characteristics of recurrent fractures. Osteoporos Int. 2018; 29(8):1747-1757. PMC: 6076437. DOI: 10.1007/s00198-018-4502-0. View

Johansson H, Siggeirsdottir K, Harvey N, Oden A, Gudnason V, McCloskey E . Imminent risk of fracture after fracture. Osteoporos Int. 2016; 28(3):775-780. PMC: 5338733. DOI: 10.1007/s00198-016-3868-0. View

Hannan M, Weycker D, McLean R, Sahni S, Bornheimer R, Barron R . Predictors of Imminent Risk of Nonvertebral Fracture in Older, High-Risk Women: The Framingham Osteoporosis Study. JBMR Plus. 2019; 3(6):e10129. PMC: 6636767. DOI: 10.1002/jbm4.10129. View

Bliuc D, Alarkawi D, Nguyen T, Eisman J, Center J . Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2014; 30(4):637-46. DOI: 10.1002/jbmr.2393. View

Kanis J, Johnell O, De Laet C, Johansson H, Oden A, Delmas P . A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004; 35(2):375-82. DOI: 10.1016/j.bone.2004.03.024. View

10.

Kanis J, Johnell O, Oden A, Johansson H, McCloskey E . FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008; 19(4):385-97. PMC: 2267485. DOI: 10.1007/s00198-007-0543-5. View

11.

Hippisley-Cox J, Coupland C . Derivation and validation of updated QFracture algorithm to predict risk of osteoporotic fracture in primary care in the United Kingdom: prospective open cohort study. BMJ. 2012; 344:e3427. DOI: 10.1136/bmj.e3427. View

12.

van Geel T, van Helden S, Geusens P, Winkens B, Dinant G . Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. 2008; 68(1):99-102. DOI: 10.1136/ard.2008.092775. View

13.

Hippisley-Cox J, Coupland C, Brindle P . The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study. BMJ Open. 2014; 4(8):e005809. PMC: 4156807. DOI: 10.1136/bmjopen-2014-005809. View

14.

Garcia-Gil M, Hermosilla E, Prieto-Alhambra D, Fina F, Rosell M, Ramos R . Construction and validation of a scoring system for the selection of high-quality data in a Spanish population primary care database (SIDIAP). Inform Prim Care. 2012; 19(3):135-45. DOI: 10.14236/jhi.v19i3.806. View

15.

Pottegard A, Schmidt S, Wallach-Kildemoes H, Sorensen H, Hallas J, Schmidt M . Data Resource Profile: The Danish National Prescription Registry. Int J Epidemiol. 2016; 46(3):798-798f. PMC: 5837522. DOI: 10.1093/ije/dyw213. View

16.

Schmidt M, Schmidt S, Sandegaard J, Ehrenstein V, Pedersen L, Sorensen H . The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol. 2015; 7:449-90. PMC: 4655913. DOI: 10.2147/CLEP.S91125. View

17.

Imel E, Eckert G, Modi A, Li Z, Martin J, de Papp A . Proportion of osteoporotic women remaining at risk for fracture despite adherence to oral bisphosphonates. Bone. 2015; 83:267-275. DOI: 10.1016/j.bone.2015.11.021. View

18.

Black D, Thompson D, Bauer D, Ensrud K, Musliner T, Hochberg M . Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. J Clin Endocrinol Metab. 2000; 85(11):4118-24. DOI: 10.1210/jcem.85.11.6953. View

19.

Harris S, Watts N, Genant H, McKeever C, Hangartner T, Keller M . Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999; 282(14):1344-52. DOI: 10.1001/jama.282.14.1344. View

20.

Prieto-Alhambra D, Pages-Castella A, Wallace G, Javaid M, Judge A, Nogues X . Predictors of fracture while on treatment with oral bisphosphonates: a population-based cohort study. J Bone Miner Res. 2013; 29(1):268-74. PMC: 3867340. DOI: 10.1002/jbmr.2011. View