Osteoporosis Research Today is a free monthly online journal that collates and summarizes the latest research about Osteoporosis, including details on symptoms, treatment, prevention, causes.

Longitudinal progression of fracture prevalence through a population of postmenopausal women with osteoporosis.

Lindsay R, Pack S, Li Z

Helen Hayes Hospital, Route 9 W, West Haverstraw, NY 10993, USA. lindsayr@helenhayeshosp.org

AIM: To determine the longitudinal progression of fractures through a population of osteoporotic women with no existing vertebral fractures. METHODS: The probability of having one or more vertebral fractures in the next year given a current status of 0-13 existing vertebral fractures was estimated using data from control patients of an osteoporosis clinical trial program. Fracture probabilities were used to form a transition matrix that models the change in fracture state from one year to the next. A Markov model was used to show the distribution of fracture prevalence over time for a population of women with osteoporosis but, initially, with no existing vertebral fractures. RESULTS: An osteoporotic woman without existing vertebral fractures has a 7.7% chance (95% CI, 5.8% to 9.9%) of having a vertebral fracture within 1 year. After 5 years, 33% (95% CI, 25% to 41%) will have developed vertebral fractures, of which 11% (95% CI, 8% to 16%) will have > or =2 fractures. After 10 years, 55% (95% CI, 44% to 65%) will have developed vertebral fractures, of which 29% (95% CI, 22% 37%) will have > or =2 fractures. Each 1% absolute reduction in the annual first-fracture risk corresponds to an approximate 4% reduction in the 5-year fracture incidence. Therefore, reducing the risk of first fracture from 8% to 2% reduces the 5-year fracture incidence from approximately 34% to approximately 10%. CONCLUSIONS: Fracture prevalence rapidly increases over time in a population of osteoporotic women despite treatment with calcium and vitamin D supplements. Identifying and treating patients at risk of fracture, but who have not yet sustained a fracture, will substantially reduce the long-term burden of osteoporosis.

Published 23 February 2005 in Osteoporos Int, 16(3): 306-12.
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