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Erschienen in: Osteoporosis International 1/2010

01.01.2010 | Original Article

Application of the National Osteoporosis Foundation Guidelines to postmenopausal women and men: the Framingham Osteoporosis Study

verfasst von: S. D. Berry, D. P. Kiel, M. G. Donaldson, S. R. Cummings, J. A. Kanis, H. Johansson, E. J. Samelson

Erschienen in: Osteoporosis International | Ausgabe 1/2010

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Abstract

Summary

We applied the 2008 National Osteoporosis Foundation (NOF) Guidelines to Framingham Osteoporosis Study participants and found nearly one half of Caucasian postmenopausal women and one sixth of men aged 50 years and older would be recommended for osteoporosis treatment. Given the high proportion of persons recommended for treatment, NOF Guidelines may need to be re-evaluated with respect to budget impact.

Introduction

Little is known about the public health impact of the NOF Guidelines. Therefore, we determined the proportion of US Caucasians recommended for treatment of osteoporosis according to NOF Guidelines (2003 and 2008).

Methods

One thousand nine hundred and forty-six postmenopausal women and 1,681 men aged ≥50 years from the Framingham Study with information on bone mineral density (1987–2001) were included. Information on clinical predictors was used to estimate the 10-year probability of hip and major osteoporotic fracture by FRAX® (version 3.0).

Results

Overall proportion of women meeting treatment criterion was less when the 2008 NOF Guidelines were applied (41.1%) compared with 2003 Guidelines (47.8%). The proportion of women aged <65 years meeting treatment criterion was much less when applying 2008 Guidelines (23.1% in 2003, 8.3% in 2008), whereas the proportion of women aged >75 years increased slightly (78.3% in 2003, 86.0% in 2008). Seventeen percent of men aged ≥50 years met treatment criterion (2.5% aged 50–64 years, 49.8% aged >75 years).

Conclusions

Nearly one half of Caucasian postmenopausal women and one sixth of men aged 50 years and older would be recommended for osteoporosis treatment according to 2008 NOF Guidelines. Given the high proportion of persons recommended for treatment, NOF Guidelines may need to be re-evaluated with respect to budget impact.
Literatur
1.
Zurück zum Zitat Melton LJ III (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18:1139–1141CrossRefPubMed Melton LJ III (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18:1139–1141CrossRefPubMed
2.
Zurück zum Zitat Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475CrossRefPubMed Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475CrossRefPubMed
3.
Zurück zum Zitat Sawka AM, Papaioannou A, Adachi JD, Gafni A, Hanley DA, Thabane L (2005) Does alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women. BMC Musculoskelet Disord 6:39CrossRefPubMed Sawka AM, Papaioannou A, Adachi JD, Gafni A, Hanley DA, Thabane L (2005) Does alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women. BMC Musculoskelet Disord 6:39CrossRefPubMed
4.
Zurück zum Zitat Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD004523 Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD004523
5.
Zurück zum Zitat Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD001155 Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev CD001155
6.
Zurück zum Zitat Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK (2008) Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians. Ann Intern Med 148:680–684PubMed Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK (2008) Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians. Ann Intern Med 148:680–684PubMed
7.
Zurück zum Zitat Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK (2008) Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med 149:404–415PubMed Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK (2008) Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med 149:404–415PubMed
8.
Zurück zum Zitat (2003) Physician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington DC, pp 1–29 (2003) Physician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington DC, pp 1–29
9.
Zurück zum Zitat Melton LJ III, Eddy DM, Johnston CC Jr (1990) Screening for osteoporosis. Ann Intern Med 112:516–528PubMed Melton LJ III, Eddy DM, Johnston CC Jr (1990) Screening for osteoporosis. Ann Intern Med 112:516–528PubMed
10.
Zurück zum Zitat (2008) Physician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington DC pp 1–36 (2008) Physician's guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington DC pp 1–36
11.
Zurück zum Zitat Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397CrossRefPubMed Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397CrossRefPubMed
13.
Zurück zum Zitat Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ III, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046CrossRefPubMed Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ III, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046CrossRefPubMed
14.
Zurück zum Zitat Donaldson M, Cawthon P, Lui L, Schousboe J, Ensrud K, Taylor B, Cauley J, Hillier T, Black D, Bauer D, Cummings S (2008) Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res 24(4):675–680CrossRef Donaldson M, Cawthon P, Lui L, Schousboe J, Ensrud K, Taylor B, Cauley J, Hillier T, Black D, Bauer D, Cummings S (2008) Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res 24(4):675–680CrossRef
15.
Zurück zum Zitat Dawson-Hughes B, Looker AC, Tosteson ANA, Johansson H, Kanis JA, Melton LJ III (2009) The potential impact of new national osteoporosis foundation guidance on treatment patterns. Osteoporos Int. doi:10.1007/s00198-009-1034-7 Dawson-Hughes B, Looker AC, Tosteson ANA, Johansson H, Kanis JA, Melton LJ III (2009) The potential impact of new national osteoporosis foundation guidance on treatment patterns. Osteoporos Int. doi:10.​1007/​s00198-009-1034-7
16.
Zurück zum Zitat Dawber TR, Meadors GF, Moore FE Jr (1951) Epidemiological approaches to heart disease: the Framingham study. Am J Public Health 41:279–281CrossRef Dawber TR, Meadors GF, Moore FE Jr (1951) Epidemiological approaches to heart disease: the Framingham study. Am J Public Health 41:279–281CrossRef
17.
Zurück zum Zitat Kannel WB, Feinleib M, McNamara PM, Garrison RJ, Castelli WP (1979) An investigation of coronary heart disease in families. The Framingham Offspring Study. Am J Epidemiol 110:281–290PubMed Kannel WB, Feinleib M, McNamara PM, Garrison RJ, Castelli WP (1979) An investigation of coronary heart disease in families. The Framingham Offspring Study. Am J Epidemiol 110:281–290PubMed
18.
Zurück zum Zitat Kiel DP, Mercier CA, Dawson-Hughes B, Cali C, Hannan MT, Anderson JJ (1995) The effects of analytic software and scan analysis technique on the comparison of dual X-ray absorptiometry with dual photon absorptiometry of the hip in the elderly. J Bone Miner Res 10:1130–1136PubMedCrossRef Kiel DP, Mercier CA, Dawson-Hughes B, Cali C, Hannan MT, Anderson JJ (1995) The effects of analytic software and scan analysis technique on the comparison of dual X-ray absorptiometry with dual photon absorptiometry of the hip in the elderly. J Bone Miner Res 10:1130–1136PubMedCrossRef
19.
Zurück zum Zitat Kiel DP, Felson DT, Anderson JJ, Wilson PW, Moskowitz MA (1987) Hip fracture and the use of estrogens in postmenopausal women. The Framingham Study. N Engl J Med 317:1169–1174PubMedCrossRef Kiel DP, Felson DT, Anderson JJ, Wilson PW, Moskowitz MA (1987) Hip fracture and the use of estrogens in postmenopausal women. The Framingham Study. N Engl J Med 317:1169–1174PubMedCrossRef
20.
Zurück zum Zitat Samelson EJ, Hannan MT, Zhang Y, Genant HK, Felson DT, Kiel DP (2006) Incidence and risk factors for vertebral fracture in women and men: 25-year follow-up results from the population-based Framingham study. J Bone Miner Res 21:1207–1214CrossRefPubMed Samelson EJ, Hannan MT, Zhang Y, Genant HK, Felson DT, Kiel DP (2006) Incidence and risk factors for vertebral fracture in women and men: 25-year follow-up results from the population-based Framingham study. J Bone Miner Res 21:1207–1214CrossRefPubMed
21.
Zurück zum Zitat Ettinger D, Black D, Dawson-Hughes B, Pressman AR, Melton LJ III (2009) Updated fracture incidence rates for the U.S. version of FRAXR. Osteoporos Int. doi:10.1007/s00198-009-1032-9 Ettinger D, Black D, Dawson-Hughes B, Pressman AR, Melton LJ III (2009) Updated fracture incidence rates for the U.S. version of FRAXR. Osteoporos Int. doi:10.​1007/​s00198-009-1032-9
22.
Zurück zum Zitat Kanis JA, Johansson H, Odén O, Dawson-Hughes B, Melton LJ III, McCloskey EV (2009) The effects of a FRAX® revision for the US. Osteoporos Int. doi:10.1007/s00198-009-1033-8 Kanis JA, Johansson H, Odén O, Dawson-Hughes B, Melton LJ III, McCloskey EV (2009) The effects of a FRAX® revision for the US. Osteoporos Int. doi:10.​1007/​s00198-009-1033-8
23.
Zurück zum Zitat McCloskey EV, Vasireddy S, Threlkeld J, Eastaugh J, Parry A, Bonnet N, Beneton M, Kanis JA, Charlesworth D (2008) Vertebral fracture assessment (VFA) with a densitometer predicts future fractures in elderly women unselected for osteoporosis. J Bone Miner Res 23:1561–1568CrossRefPubMed McCloskey EV, Vasireddy S, Threlkeld J, Eastaugh J, Parry A, Bonnet N, Beneton M, Kanis JA, Charlesworth D (2008) Vertebral fracture assessment (VFA) with a densitometer predicts future fractures in elderly women unselected for osteoporosis. J Bone Miner Res 23:1561–1568CrossRefPubMed
24.
Zurück zum Zitat Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT (2002) Effect of birth cohort on risk of hip fracture: age specific incidence rates in the Framingham study. Am J Public Health 92(5):858–862CrossRefPubMed Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT (2002) Effect of birth cohort on risk of hip fracture: age specific incidence rates in the Framingham study. Am J Public Health 92(5):858–862CrossRefPubMed
25.
Zurück zum Zitat Zhang Y, Guo X, Saitz R, Levy D, Sartini E, Niu J, Ellison RC (2008) Secular trends in alcohol consumption over 50 years: the Framingham study. Am J Med 121(8):695–701CrossRefPubMed Zhang Y, Guo X, Saitz R, Levy D, Sartini E, Niu J, Ellison RC (2008) Secular trends in alcohol consumption over 50 years: the Framingham study. Am J Med 121(8):695–701CrossRefPubMed
26.
Zurück zum Zitat U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (1998) Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaskan Natives, Asian Americans and Pacific Islanders, and Hispanics: a Report of the Surgeon General. Atlanta, GA U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (1998) Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaskan Natives, Asian Americans and Pacific Islanders, and Hispanics: a Report of the Surgeon General. Atlanta, GA
28.
Zurück zum Zitat Mussolino ME, Madans JH, Gillum RF (2003) Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study. Ann Epidemiol 13:692–697CrossRefPubMed Mussolino ME, Madans JH, Gillum RF (2003) Bone mineral density and mortality in women and men: the NHANES I epidemiologic follow-up study. Ann Epidemiol 13:692–697CrossRefPubMed
29.
Zurück zum Zitat Tosteson AN, Burge RT, Marshall DA, Lindsay R (2008) Therapies for treatment of osteoporosis in US women: cost-effectiveness and budget impact considerations. Am J Manag Care 14:605–615PubMed Tosteson AN, Burge RT, Marshall DA, Lindsay R (2008) Therapies for treatment of osteoporosis in US women: cost-effectiveness and budget impact considerations. Am J Manag Care 14:605–615PubMed
30.
Zurück zum Zitat Tosteson AN, Melton LJ III, Dawson-Hughes B, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447CrossRefPubMed Tosteson AN, Melton LJ III, Dawson-Hughes B, Baim S, Favus MJ, Khosla S, Lindsay RL (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447CrossRefPubMed
31.
Zurück zum Zitat Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A (2008) Case finding for the management of osteoporosis with FRAX(R)-assessment and intervention thresholds for the UK. Osteoporos Int 19(10):1395–1408CrossRefPubMed Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A (2008) Case finding for the management of osteoporosis with FRAX(R)-assessment and intervention thresholds for the UK. Osteoporos Int 19(10):1395–1408CrossRefPubMed
Metadaten
Titel
Application of the National Osteoporosis Foundation Guidelines to postmenopausal women and men: the Framingham Osteoporosis Study
verfasst von
S. D. Berry
D. P. Kiel
M. G. Donaldson
S. R. Cummings
J. A. Kanis
H. Johansson
E. J. Samelson
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 1/2010
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-009-1127-3

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