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
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
ce487fb4-d360-4aac-9d17-9466d6cba145
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Cooper, Cyrus
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March 2021
Fuggle, Nicholas
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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).
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.
Text
Cyrus Cooper Sheffield BP Paper Final_20_12_11_clean
- Accepted Manuscript
More information
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
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Date deposited: 27 Jan 2021 17:31
Last modified: 18 Mar 2024 05:08
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Author:
Jean Zhang
Author:
M. Kassim Javaid
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