Treatment of high fracture risk patients in routine clinical practice
- PDF / 381,907 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 30 Downloads / 169 Views
ORIGINAL ARTICLE
Treatment of high fracture risk patients in routine clinical practice Olga Lesnyak 1,2 & Elena Gladkova 1,2 & Nikolay Aleksandrov 3 & Zhanna Belaya 4 & Ksenia Belova 5 & Natalya Bezlyudnaya 6 & Olga Dobrovolskaya 7 & Alexandr Dreval 8 & Olga Ershova 5 & Tatiana Grebennikova 4 & Irina Kryukova 8 & Sergey Mazurenko 9 & Diana Priymak 3 & Ludmila Rozhinskaya 4 & Rusanna Samigullina 1 & Alexander Solodovnikov 10 & Natalya Toroptsova 7 Received: 2 July 2020 / Accepted: 3 November 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary A retrospective cohort study determined the high incidence of recurrent fractures in osteoporotic patients with high fracture risk during the observation. The strategy of starting treatment with more potent regimens (zoledronic acid, denosumab and/or teriparatide) seems to have the best secondary fracture prevention efficacy. Objective This paper describes the various medical therapy regimens prescribed to osteoporotic patients with high fracture risk and the result of treatment. Methods We carried out a retrospective cohort study in selected Osteoporosis Centers. Patients were considered to have high fracture risk in case of a history of a low-energy hip fracture or two or more vertebral or other site fractures. A total of 812 subjects (768 women and 44 men) aged 36–95 years were included. The observation period was 2285.1 patient-years. Demographic data, clinical findings, and BMD data obtained by DXA, as well as a history of fractures that had occurred during the follow-up, were included in the analysis. Results Overall, at baseline, there were 637 non-vertebral fractures including 104 hip fractures. A total of 590 patients had vertebral fractures; of these, 69% suffered multiple fractures. Being on treatment, 119 (14.7%) patients developed new vertebral and non-vertebral fractures. The incidence of new non-vertebral fractures and hip fractures was 39.4 and 13.1 per 1000 patientyears. The total number of vertebral fractures increased by 24.8% from 1353 to 1689. The best results of the treatment were achieved in patients who were started on zoledronic acid, denosumab, or teriparatide and had an adequate duration of treatment. Although these patients had significantly lower BMD values at the time of diagnosis compared with other patients, they showed a lower incidence of new vertebral and hip fractures, during the follow-up. Conclusion Therapy of patients at high risk of fractures started with more potent treatment regimens (zoledronic acid, denosumab and/or teriparatide) of adequate duration was more effective in terms of prevention of new vertebral and hip fractures as compared with other treatment options. However, treatment appears to be challenging given the number of recurrent fractures in patients on treatment and the frequency of drug withdrawal or replacement. Keywords Osteoporosis . High fracture risk . Clinical practice . Treatment . Fractures
* Olga Lesnyak [email protected]
5
Yaroslavl State Medical U
Data Loading...
