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State of the art in osteoporosis risk assessment and treatment

State of the art in osteoporosis risk assessment and treatment
State of the art in osteoporosis risk assessment and treatment
Background

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm, and humerus. Over recent decades, it has evolved from being viewed as an inevitable consequence of ageing, to being recognised as a serious and eminently treatable disease.

Materials and methods

In this article, we review the literature pertaining to the epidemiology of osteoporosis, associated health burden, approaches to risk assessment and treatment.

Results

Although there is some evidence that fracture incidence has reached a plateau, or even started to decline, in the developed world, an ageing population and adoption of westernised lifestyles in transitioning populations is leading to an increasing burden of osteoporosis across the world. Whilst the clinical definition of osteoporosis has been based solely on bone mineral density, the prediction of fracture at the individual level has been improved by consideration of clinical risk factors in tools such as FRAX®, derived from a greater understanding of the epidemiology of osteoporosis. Such advances in approaches to primary and secondary prevention of fractures, coupled with elucidation of the underlying biology, and the development of a range of highly effective antiosteoporosis medications, have enabled a step change in our ability to prevent osteoporosis-related fractures. However, there remains a substantial disparity between the number of individuals at high fracture risk and number treated globally.

Conclusion

Urgent work is needed at the level of health care systems, national and international policy, and in communication with patients and public, to ensure that all patients who should receive treatment for osteoporosis actually do so.
1720-8386
1-16
Liu, Justin
5fdb7afb-738d-421f-8e49-a5fc251e3d7c
Curtis, Elizabeth
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Liu, Justin
5fdb7afb-738d-421f-8e49-a5fc251e3d7c
Curtis, Elizabeth
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145

Liu, Justin, Curtis, Elizabeth, Cooper, Cyrus and Harvey, Nicholas (2019) State of the art in osteoporosis risk assessment and treatment. Journal of Endocrinological Investigation, 1-16. (doi:10.1007/s40618-019-01041-6).

Record type: Article

Abstract

Background

Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm, and humerus. Over recent decades, it has evolved from being viewed as an inevitable consequence of ageing, to being recognised as a serious and eminently treatable disease.

Materials and methods

In this article, we review the literature pertaining to the epidemiology of osteoporosis, associated health burden, approaches to risk assessment and treatment.

Results

Although there is some evidence that fracture incidence has reached a plateau, or even started to decline, in the developed world, an ageing population and adoption of westernised lifestyles in transitioning populations is leading to an increasing burden of osteoporosis across the world. Whilst the clinical definition of osteoporosis has been based solely on bone mineral density, the prediction of fracture at the individual level has been improved by consideration of clinical risk factors in tools such as FRAX®, derived from a greater understanding of the epidemiology of osteoporosis. Such advances in approaches to primary and secondary prevention of fractures, coupled with elucidation of the underlying biology, and the development of a range of highly effective antiosteoporosis medications, have enabled a step change in our ability to prevent osteoporosis-related fractures. However, there remains a substantial disparity between the number of individuals at high fracture risk and number treated globally.

Conclusion

Urgent work is needed at the level of health care systems, national and international policy, and in communication with patients and public, to ensure that all patients who should receive treatment for osteoporosis actually do so.

Text
JL OP review R1 2019_03_20 clean - Accepted Manuscript
Restricted to Repository staff only until 21 March 2020.
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Liu 2019 Article State Of The Art In Osteoporosis - Version of Record
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More information

Accepted/In Press date: 22 March 2019
e-pub ahead of print date: 12 April 2019

Identifiers

Local EPrints ID: 429298
URI: https://eprints.soton.ac.uk/id/eprint/429298
ISSN: 1720-8386
PURE UUID: 6cba37d7-5140-449f-9073-7b22087e9d97
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 26 Mar 2019 17:30
Last modified: 15 Aug 2019 00:52

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