Vol 70, No 6 (2019)
Original paper
Published online: 2019-11-19

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The efficacy of pharmacotherapy in postmenopausal osteoporosis: a longitudinal observational study

Wojciech Pluskiewicz1, Piotr Adamczyk2, Edward Franek3, Ewa Sewerynek4, Hanna Wichrowska5, Luiza Napiórkowska5, Michał Stuss4, Aleksandra Rozwandowicz4, Bogna Drozdzowska6
Pubmed: 31909456
Endokrynol Pol 2019;70(6):473-477.

Abstract

Introduction: The aim of the study was an assessment of longitudinal changes in fracture probability in postmenopausal women.

Material and methods: A group of 226 postmenopausal women at baseline mean age 66.46 ± 7.96 years were studied. There were 21 women without therapy, 102 taking calcium + vitamin D, and 103 women on antiresorptive therapy, in the study group. Data concerning clinical risk factors for osteoporosis and hip BMD were gathered. Fracture probability for major and hip fractures was established using FRAXTM.

Results: Mean follow-up time was 2.43 ± 0.59 years. Baseline FRAX value in the whole group for major fracture was 7.1 ± 4.18, and at follow-up it was 7.44 ± 4.04. Respective results for FRAX for hip fracture were 3.17 ± 2.69 and 3.02 ± 2.35. In the whole group the probability for major fractures significantly increased during follow-up (p < 0.05) and for hip fracture did not change. In non-treated patients and patients taking calcium + vitamin D the fracture probability increased significantly. In patients on antiresorptive therapy the fracture probability did not change, which was connected with an improvement in bone status assessed by DXA. Femoral neck T-score in the whole group did not change, in those not treated and taking calcium + vitamin D it decreased significantly (p < 0.05), while in treated women it increased significantly (p < 0.05). In patients with improved bone status the FRAX values for major and hip fractures decreased by 0.44 ± 1.62 and 0.36 ± 1.19, respectively. Conversely, in patients with worsening T-score value the FRAX values increased by 1.33 ± 1.42 and 0.66 ± 1.25, respectively.

Conclusion: Antiresorptive therapy stabilises fracture probability in postmenopausal women due to improvement in bone status.

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References

  1. Kanis JA, Johnell O, Oden A, et al. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008; 19(4): 385–397.
  2. Camacho PM, Petak SM, Binkley N, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis — 2016. Endocr Pract. 2016; 22(Suppl 4): 1–42.
  3. Marcinkowska M, Ignaszak-Szczepaniak M, Wawrzyniak A, et al. A discussion of the intervention thresholds in osteoporosis treatment in Poland. Endokrynol Pol. 2011; 62(1): 30–36.
  4. Franek E, Wichrowska H, Gozdowski D, et al. WHO fracture risk calculator (FRAX) in the assessment of obese patients with osteoporosis. Endokrynol Pol. 2009; 60(2): 82–87.
  5. Lorenc RS, Głuszko P, Karczmarewicz E, et al. [Diagnostic and therapeutic recommendations in osteoporosis] (in Polish). Medycyna Praktyczna Reumatologia. 2013; 1(special issue): 1–44.
  6. Lorenc R, Głuszko P, Franek E, et al. Guidelines for the diagnosis and management of osteoporosis in Poland : Update 2017. Endokrynol Pol. 2017; 68(5): 604–609.
  7. Pluskiewicz W, Drozdzowska B, Adamczyk P. Ten-year fracture risk in the assessment of osteoporosis management efficacy in postmenopausal women: a pilot study. Climacteric. 2013; 16(1): 117–126.
  8. Leslie WD, Majumdar SR, Lix LM, et al. Can change in FRAX score be used to "treat to target"? A population‐based cohort study. J Bone Miner Res. 2014; 29(5): 1074–1080.
  9. Tamaki J, Iki M, Kadowaki E, et al. Fracture risk prediction using FRAX®: a 10-year follow-up survey of the Japanese Population-Based Osteoporosis (JPOS) Cohort Study. Osteoporos Int. 2011; 22(12): 3037–3045.
  10. Rubin KH, Abrahamsen Bo, Friis-Holmberg T, et al. Comparison of different screening tools (FRAX®, OST, ORAI, OSIRIS, SCORE and age alone) to identify women with increased risk of fracture. A population-based prospective study. Bone. 2013; 56(1): 16–22.
  11. Li G, Thabane L, Papaioannou A, et al. Comparison between frailty index of deficit accumulation and fracture risk assessment tool (FRAX) in prediction of risk of fractures. Bone. 2015; 77: 107–114.
  12. Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ. 2009; 339: b4229.
  13. Collins GS, Mallett S, Altman DG. Predicting risk of osteoporotic and hip fracture in the United Kingdom: prospective independent and external validation of QFractureScores. BMJ. 2011; 342: d3651.