Osteoporosis Medication Is Underused in Postmenopausal Women
Only 21.6% of postmenopausal women with osteoporosis or a history of fractures use osteoporosis pharmacotherapy, according to a recent analysis. Factors associated with a lower likelihood of medication use are black or African American race, body mass index (BMI) of at least 30, current tobacco use, and a history of arthritis.
It is well established that osteoporotic fractures are associated with high morbidity, mortality, and cost. However, less is known about the characteristics of women taking osteoporosis pharmacotherapy.
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In their analysis of the Women’s Health Initiative (WHI) clinical trials, the researchers evaluated 13,990 postmenopausal women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and had available medication data.
Data from visits prior to and immediately after the first fracture event or osteoporosis diagnosis were assessed for medication use. Factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis were identified using a full logistic regression model.
After a median follow-up of 13.9 years, 21.6% women had reported taking an osteoporosis medication other than estrogen. Factors associated with a significantly higher likelihood of osteoporosis medication use were a higher daily calcium intake, a diagnosis of either osteoporosis alone or both osteoporosis and a fracture, Asian or Pacific Islander race or ethnicity, higher income, and past or present hormone therapy use.
Factors associated with a lower likelihood of using osteoporosis treatment were black or African American race or ethnicity, a body mass index of at least 30 kg/m2, current tobacco use, and history of arthritis.
“Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study,” the researchers concluded.
“Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. 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.”
—Christina Vogt
Reference:
Sattari M, Cauley JA, Garvan C, et al. Osteoporosis in the women’s health initiative: another treatment gap? Am J Med. 2017;130(8):937-948. http://dx.doi.org/10.1016/j.amjmed.2017.02.042.