Majority of Older Women in Europe at Risk of Fragility Fractures Not Treated for Osteoporosis

New study data are shining a light on gaps in the diagnosis and treatment of osteoporosis in Europe.

The study of nearly 4000 participants in primary care across 8 European countries found that 55% of women over age 70 are at risk of fragility fractures, but 75% of these women are not treated for osteoporosis. Results of the study were presented during the World Congress of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases.

“This real-world study further proves that an underdiagnosis of osteoporosis in Europe is a major barrier to treatment,” David M. Reese, MD, executive vice president of Research and Development at Amgen said in a statement. “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.”

The observed treatment gap was less prevalent among women with a recorded diagnosis of osteoporosis compared with women who did not have a recorded diagnosis.

The study enrolled 3798 women aged 70 or older who visited their primary care physician—mainly for other existing conditions—in Belgium, France, Germany, Ireland, Poland, Slovakia, Switzerland, or the United Kingdom. Through self-reported questionnaires and medical records, researchers documented patient demographics, treatment history, and clinical risk factors.

Increased risk of fragility fracture was determined if a patient had at least 1 of the following:

• History of previous fractures after age 50
• FRAX score with a 10-year probability of hip and major osteoporotic fracture above country-specific FRAX thresholds
• Bone density results showing a bone mineral density T-score of -2.5 or less

FRAX risk factor prevalence ranged from 32% (prior fracture) to 1% (3 or more alcoholic drinks per day). The researchers determine that 2077 women had an increased risk of fracture, and only 31% of these patients had a recorded diagnosis of osteoporosis.

There was a small proportion (10%) of patients who did not meet the study definition of increased risk for fragility fracture that had a previous diagnosis of osteoporosis.

“Based on the results, future strategies need to increase awareness and facilitate the diagnosis of patients at risk in order to improve treatment of osteoporosis and prevent fragility fractures from happening,” said Eugene McCloskey, MD, 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, in a statement.

These findings come shortly after a US-based study examining data from the Department of Veterans Affairs medical center found that older women are far more likely to have their bone density measured and be treated for osteoporosis compared with older men.