Has osteoporosis treatment failed when a fracture occurs?

August 31, 2012

The International Osteoporosis Foundation (IOF) has published practical guidelines to assist clinicians in assessing treatment efficacy in patients who experience a fracture while on medication for osteoporosis.

therapy typically reduces the risk of fracture in the range of 30-70% for vertebral fractures, 40-50% for hip fractures and 15-20% for non-. Nevertheless, even an does not completely eliminate the risk of fracture, and some patients will experience a fracture while complying with their prescribed treatment.

This situation is not just worrying for the patient, it also poses a challenge for the physician who must decide whether to continue or discontinue with the . Does the fracture signify that the patient has failed to respond to the particular treatment? Should the type of treatment be changed? Or is the patient one of a significant minority who fails to respond to available treatments, for a number of many possible reasons?

The IOF Inadequate Responders Working Group, comprised of international experts on IOF's Committee of Scientific Advisors, outlines many of the issues associated with in the treatment of osteoporosis. Professor Adolfo Diez-Perez, chair of the Working Group, explains, "Treatment issues are extremely complex. In addition there is a scarcity of data about the effectiveness of alternative treatments when one has been deemed to have failed. Notwithstanding these complexities and limitations, the Working Group has used the best available evidence to create a check list of pragmatic criteria which can help doctors define treatment failure and take appropriate action."

The position paper, published in the journal 'Osteoporosis International', outlines how the response to treatment in patients who have been complying with their treatment for at least six months can be assessed on the basis of the number of fractures, changes in and bone turnover markers.

Professor Cyrus Cooper, chair of the IOF Committee of Scientific Advisers, stated: "Recent advances in the management of osteoporosis have led to large numbers of patients being treated with a variety of drugs. An increasingly frequent clinical conundrum is the management of a patient who sustains a fracture while on treatment. Although patient and physician may view this as a sign of treatment failure, this is not always the case. The objective of the current practical guidance was to provide a clinical pathway whereby physicians can ascertain whether a patient has failed to respond adequately to an anti-osteoporosis treatment. As a result, doctors will be able to define more effectively, and take appropriate action. The algorithm produced pays testimony to the expert input from a host of international scientific advisers, coming together to address this important clinical topic in a timely and efficient manner."

Explore further: IOF urges systematic osteoporosis management after vertebral fracture augmentation

More information: Treatment failure in osteoporosis A. Diez-Perez, J. D. Adachi, D. Agnusdei, J. P. Bilezikian, J. E. Compston, S. R. Cummings, R. Eastell, E. F. Eriksen, J. Gonzalez-Macias and U. A. Liberman, et al. Osteoporosis International 2012, DOI: 10.1007/s00198-012-2093-8

Related Stories

IOF urges systematic osteoporosis management after vertebral fracture augmentation

August 1, 2011
A working group of the International Osteoporosis Foundation (IOF) has issued a literature review of prospective controlled studies comparing the efficacy and safety of two minimally invasive techniques for vertebral augmentation ...

New review outlines screening strategies for osteoporosis in young adults

June 19, 2012
Much of the research defining osteoporosis and fracture risk has focused on older adults, i.e. postmenopausal women and men over the age of 50. While older adults are at highest risk of osteoporosis and related fractures, ...

IOF and ECTS issue guidance on management of glucocorticoid-induced osteoporosis

March 27, 2012
Oral glucocorticoids are commonly prescribed for a wide variety of disorders, most commonly for rheumatoid arthritis, obstructive pulmonary disease and inflammatory bowel diseases. However, the use of these medications can ...

Recommended for you

A dose of 'wait-and-see' reduces unnecessary antibiotic use

September 21, 2017
Asking patients to take a 'wait-and-see' approach before having their antibiotic prescriptions filled significantly reduces unnecessary use, a University of Queensland study has shown.

Individualized diets for irritable bowel syndrome better than placebo

September 21, 2017
Patients with irritable bowel syndrome who follow individualized diets based on food sensitivity testing experience fewer symptoms, say Yale researchers. Their study is among the first to provide scientific evidence for this ...

Groundbreaking investigative effort identifies gonorrhea vaccine candidates

September 19, 2017
Researchers at Oregon State University have identified a pair of proteins that show promise as the basis for a gonorrhea vaccine.

Snail fever progression linked to nitric oxide production

September 14, 2017
Bilharzia, caused by a parasitic worm found in freshwater called Schistosoma, infects around 200 million people globally and its advance can lead to death, especially in children in developing countries.

Systems analysis points to links between Toxoplasma infection and common brain diseases

September 13, 2017
More than 2 billion people - nearly one out of every three humans on earth, including about 60 million people in the United States - have a lifelong infection with the brain-dwelling parasite Toxoplasma gondii.

Study clears important hurdle toward developing an HIV vaccine

September 13, 2017
An international team of researchers has demonstrated a way of overcoming one of the major stumbling blocks that has prevented the development of a vaccine against HIV: the ability to generate immune cells that stay in circulation ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

MyPerfectBones_com
not rated yet Sep 10, 2012
Reverse bone loss and deal with the pain of osteoporosis with all natural supplements, nutrients and remedies like My Perfect Bones (google it...)

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.