Screening may reduce osteoporotic fracture risk
MedWire News: Screening middle-aged women for osteoporosis leads to increased use of hormone replacement therapy (HRT) and other treatments, trial findings indicate.
“This study strongly suggests that a population screening program to target treatment of those at risk of osteoporosis will reduce fractures,” say R Barr (University of Aberdeen, UK) and co-workers.
“It does however remain unclear which specific aspects of screening followed by therapy gives rise to this reduction in fracture risk,” they note.
The team reports on the findings from 4800 women, aged 45–54 years, who were randomly assigned to have a dual-energy X-ray absorptiometry scan of the hip and spine, or no screening.
Overall, 1764 women accepted the screening offer and 1364 controls were recruited to the study.
Screened women in the lowest quartile for bone mineral density were then advised to consider taking HRT, while those in the higher quartiles were told they need not consider HRT for osteoporosis prevention unless taking drugs that increase their risk for the condition.
The women were questioned 9 years later to determine if screening had altered use of anti-osteoporotic therapies or risk for fracture.
At follow-up, screened women were significantly more likely to have used HRT than controls (52.4% vs 44.5%). Screening was also associated with an increased use of vitamin D, calcium supplements and anti-osteoporotic medications (36.6% vs 21.6%).
Furthermore, per protocol analysis of confirmed fractures indicated that women who received screening had a 25.9% risk reduction for fracture at any site compared with unscreened controls, after adjusting for age, weight, and height.
“The significant reduction in fracture risk, associated with participation in this study, could not be explained by a reduction in falls, since the number of fallers and the number of falls in the screened and control groups were not significantly different, again implying that increased use of osteoporosis treatments was responsible,” write Barr et al.
They conclude in the journal Osteoporosis International: “Further work is required to determine the optimum age to undertake screening to ensure a cost-effective program.”
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By Lynda Williams