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The treatment gap: the missed opportunities for osteoporosis therapy

The treatment gap: the missed opportunities for osteoporosis therapy
The treatment gap: the missed opportunities for osteoporosis therapy
Despite substantial advances in delineation of the epidemiology, pathophysiology, risk assessment and treatment of osteoporosis over the last three decades, a substantial proportion of men and women at high risk of fracture remain untreated - the so-called “treatment gap”. This review summarises the important patient-, physician- and policyrelated causes of this treatment gap, before discussing in greater detail: (a) the evidence base for the efficacy of bisphosphonates in osteoporosis; (b) recent evidence relating to the adverse effects of this widely used therapeutic class, most notably atypical femoral fracture and osteonecrosis of the jaw; (c) available strategies to improve both secondary and primary prevention pathways for the management of this disorder.
Bisphosphonates, Osteoporosis, Treatment gap
8756-3282
Fuggle, Nicholas
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Curtis, Elizabeth
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Clynes, Michael
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Zhang, Jean
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Ward, Kate
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Javaid, M. Kassim
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Harvey, Nicholas
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Dennison, Elaine
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Cooper, Cyrus
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Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Curtis, Elizabeth
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Clynes, Michael
b860d3b7-12ee-42b8-8cd5-1e1abfccbee2
Zhang, Jean
437abe90-46ac-46de-8183-042c36ed3398
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Javaid, M. Kassim
64155236-2ef0-4065-b684-cf723a888117
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6

Fuggle, Nicholas, Curtis, Elizabeth, Clynes, Michael, Zhang, Jean, Ward, Kate, Javaid, M. Kassim, Harvey, Nicholas, Dennison, Elaine and Cooper, Cyrus (2021) The treatment gap: the missed opportunities for osteoporosis therapy. Bone, 144, [115833]. (doi:10.1016/j.bone.2020.115833).

Record type: Article

Abstract

Despite substantial advances in delineation of the epidemiology, pathophysiology, risk assessment and treatment of osteoporosis over the last three decades, a substantial proportion of men and women at high risk of fracture remain untreated - the so-called “treatment gap”. This review summarises the important patient-, physician- and policyrelated causes of this treatment gap, before discussing in greater detail: (a) the evidence base for the efficacy of bisphosphonates in osteoporosis; (b) recent evidence relating to the adverse effects of this widely used therapeutic class, most notably atypical femoral fracture and osteonecrosis of the jaw; (c) available strategies to improve both secondary and primary prevention pathways for the management of this disorder.

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Cyrus Cooper Sheffield BP Paper Final_20_12_11_clean - Accepted Manuscript
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Accepted/In Press date: 19 December 2020
e-pub ahead of print date: 23 December 2020
Published date: March 2021
Additional Information: Funding Information: This manuscript was prepared for presentation at the 50th Anniversary Meeting for Bisphosphonates, Sheffield, July 2019. It relies upon material published by the principal author in the IOF-ESCEO European Guidelines for the Management and Treatment of Osteoporosis (1); the IOF Report on Closing the Osteoporosis Treatment Gap (2); the IOF Working Group Report on Discontinuation of Osteoporosis Therapy (3); and a recently published review on optimising osteoporosis therapy (4). The work was funded by the UK Medical Research Council, NIHR Southampton BRC, Versus Arthritis and International Osteoporosis Foundation. Funding Information: This manuscript was prepared for presentation at the 50th Anniversary Meeting for Bisphosphonates, Sheffield, July 2019. It relies upon material published by the principal author in the IOF-ESCEO European Guidelines for the Management and Treatment of Osteoporosis (1); the IOF Report on Closing the Osteoporosis Treatment Gap (2); the IOF Working Group Report on Discontinuation of Osteoporosis Therapy (3); and a recently published review on optimising osteoporosis therapy (4). The work was funded by the UK Medical Research Council , NIHR Southampton BRC , Versus Arthritis and International Osteoporosis Foundation . Publisher Copyright: © 2020
Keywords: Bisphosphonates, Osteoporosis, Treatment gap

Identifiers

Local EPrints ID: 446197
URI: http://eprints.soton.ac.uk/id/eprint/446197
ISSN: 8756-3282
PURE UUID: 642a8f9d-84c6-4f2c-8dcd-cbce04491aa9
ORCID for Nicholas Fuggle: ORCID iD orcid.org/0000-0001-5463-2255
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Michael Clynes: ORCID iD orcid.org/0000-0001-7597-7658
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 27 Jan 2021 17:31
Last modified: 30 Oct 2023 05:37

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Contributors

Author: Nicholas Fuggle ORCID iD
Author: Michael Clynes ORCID iD
Author: Jean Zhang
Author: Kate Ward ORCID iD
Author: M. Kassim Javaid
Author: Nicholas Harvey ORCID iD
Author: Elaine Dennison ORCID iD
Author: Cyrus Cooper ORCID iD

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