In a first-of-its-kind study in osteoporosis, one in four women surveyed from Europe, North America, and Australia reported having one or more bone fractures since the age of 45 years. Among women considered to be at high risk for a fracture, only 26% reported use of bone-saving drugs, with use reported significantly less frequently in Europe than in North America and Australia. Identifying important regional differences is just one aim of a landmark observational study, the Global Longitudinal Registry of Osteoporosis in Women (GLOW), which will monitor the health of over 60,000 older women (more than or equal to 55 yrs) worldwide for 5 years. Baseline results were presented today at the 35th European Symposium on Calcified Tissues.
For women enrolled in GLOW, fractures after the age of 45 were more prevalent in Europe than in the United States, Canada and Australia. For hip fracture specifically, a prior hip fracture was reported more frequently by women in Europe (2.1%) than by women in the United States (1.7%) or in Canada/Australia (1.4%). These potential differences will be further explored in follow-up years of the study.
"We need to understand the cause for the regional differences we observe in fracture prevalence," said Dr Robert Lindsay, Professor of Clinical Medicine at Columbia University and GLOW executive committee co-chair. "One aim of GLOW is to learn from those countries that are having the greatest success at preventing fractures and to recommend best practices that will improve the bone health and lives of millions of patients around the world."
To be eligible for this multi-national study, a woman had to be aged 55 years or older and had to have visited a primary care physician for any health reason in the two years prior to the study. Since patient recruitment for GLOW was not linked to osteoporosis, the study is meant to provide a view to the bone health and quality of care of "typical" community-dwelling women in multiple geographies.
In Europe, 51% of GLOW participants reported having a bone density test, a valuable tool for diagnosing osteoporosis. This contrasts to other geographies where testing frequency was reported at 79%. Among women considered to be at high risk of fracture, only 20% of European women were taking a bone medication versus 30% of North American/Australian women.
"Despite reliable screening methods and multiple therapeutic options being available, osteoporosis remains largely under-diagnosed and under-treated," said Professor Pierre Delmas, Professor of medicine and rheumatology at University of Lyon, France, and GLOW executive committee co-chair. "Without some improvements, the burden of fractures on our families and on our healthcare systems will only grow with the aging population."
Osteoporosis-related fractures are an international public health problem responsible for increased mortality, functional impairment and additional health care costs(i),(ii). Direct costs of osteoporotic fractures in Europe alone are expected to rise from EUR31.7 billion in 2000 to EUR76.7 billion by 2050 (iii). In women over 45 years of age, osteoporosis accounts for more days spent in a hospital than diabetes, heart attack or breast cancer(iv).
Hip fractures are the most serious of osteoporosis-related fractures, causing chronic pain, reduced mobility, disability, loss of independence and an increased risk of death(i),(ii). An estimated 179,000 men and 711,000 women in Europe suffer a hip fracture each year(iii).
GLOW is a prospective, longitudinal, observational study of women 55 years of age and older who visited a primary care physician during the two years prior to the study. Over 60,000 women have been recruited through 700 primary care physicians in 17 cities in the United States, Canada, Europe, and Australia. GLOW will gather information on osteoporosis risk factors, treatment approaches, patient behaviour, and fracture outcomes with an annual patient survey over a 5 year period.
Results reported herein are from analysis of approximately 50,200 baseline surveys. Patients were categorized as high risk for fracture based on a fracture index score of less than or equal to 5, according to Black et al(v). Bone medications included bishosphonates, raloxifene, strontium ranelate, parathyroid hormone (1-84), teriparatide, tibolone, and calcitonin.
* GLOW is being conducted by The Center for Outcomes Research (COR), University of Massachusetts Medical School (UMMS), with the support of an unrestricted research grant from The Alliance for Better Bone Health. The Alliance for Better Bone Health is a collaboration between sanofi-aventis and Procter & Gamble Pharmaceuticals.