Gainesville, FL—Is therapy for osteoporosis underused in women most likely to need it?
A new study published in The American Journal of Medicine suggests that is the case.
Clinical guidelines are clear on the need to initiate pharmacotherapy in postmenopausal women with osteoporosis or a history of fracture, but University of Florida School of Medicine–led researchers found that the guidance often wasn’t followed.
“Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women,” study authors point out. “Specific attention needs to be paid to increasing treatment among women with fragility fractures, obesity, current tobacco use, history of arthritis, or of black race/ethnicity.”
Those findings were based on a post hoc analysis of the Women’s Health Initiative (WHI) clinical trials data. The study team sought to assess osteoporosis treatment and identify participant characteristics associated with prescribing osteoporosis medications after new diagnoses of osteoporosis or fracture.
To do that, they evaluated any information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis and matched it to medication usage. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years.
Results indicate that, among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, only 21.6% reported taking an osteoporosis medication other than estrogen.
Greater likelihood of getting a prescription for osteoporosis therapy included higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with white/Caucasian), higher income, and hormone therapy use (past or present), according to the study.
On the other hand, women with black/African American race/ethnicity (compared with white/Caucasian), a body mass index of 30 or greater (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and a history of arthritis were found to be less likely to use osteoporosis pharmacotherapy.
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