#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Management of proximal femoral fracture patiens and secondary prevention of fractures.
II. Secondary antiosteoporotic care.
Position Paper of the Czech Rheumatology Society, the Czech Society for Metabolic Bone Diseases, and Czech Society for Orthopedics and Traumatology


Authors: J. Štěpán 1;  J. Vaculík 2;  V. Palička 3;  P. Dungl 2;  V. Vyskočil 4;  K. Pavelka 1
Authors‘ workplace: Revmatologický ústav, 1. lékařská fakulta UK, Praha 1;  Ortopedická klinika IPVZ FN Na Bulovce, Praha 2;  Osteocentrum, Fakultní nemocnice, Hradec Králové 3;  Klinika ortopedie a traumatologie pohybového ústrojí Fakultní nemocnice, Plzeň 4
Published in: Čes. Revmatol., 23, 2015, No. 2, p. 43-58.
Category: Recomendation

Overview

Hip fractures disproportionately affect elderly male and female patients, and may result in impairment of mobility, loss of quality of life, increased health resource utilization and even in death. Despite strong evidence indicating that the occurrence of a hip fracture increases the risk of other osteoporotic fractures including recurrent hip fractures, secondary prevention of fractures in older patients with hip fractures is not adequately provided. One explanation for this decrease is the perception that it is too late to alter the course of the disease in its late stage. The management of such patients should include assessing clinical diagnosis, treating osteoporosis and preventing falls. Based on clinical trials and experience, this collective position of professional societies reviews the anti-fracture measures and efficacy and safety of antiosteoporotic agents in this high-risk elderly population of patients with recent low trauma hip fractures. Available pharmacological therapies for the treatment of osteoporosis include calcium and vitamin D, antiresorptive drugs such as bisphosphonates and denosumab, and the bone forming drug teriparatide. Many elderly patients with established osteoporosis have multiple comorbid conditions, and demonstrated drug safety in this frail population is critically important.

Key words:
Hip, osteoporosis, secondary prevention, fracture


Sources

1. Haentjens P, Magaziner J, Colon–Emeric CS, et al. Meta–analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 2010; 152(6): 380–90.

2. Boonen S, Autier P, Barette M, Vanderschueren D, Lips P, Haentjens P. Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 2004; 15(2): 87–94.

3. Hallberg I, Bachrach–Lindstrom M, Hammerby S, Toss G, Ek AC. Health-related quality of life after vertebral or hip fracture: a seven–year follow–up study. BMC Musculoskelet Disord 2009; 10: 135.

4. Štěpán J, Šmíd M, Prokeš M, et al. Ekonomicke aspekty osteoporózy. [Economic aspects of osteoporosis]. Čas Lék Česk 1998; 137(23): 707–15.

5. Burge R, Dawson–Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis–related fractures in the United States, 2005–2025. J Bone Miner Res 2007; 22(3): 465–75.

6. Cooper C. The crippling consequences of fractures and their impact on quality of life. Am J Med 1997; 103(2a): 12s–7s.

7. Johansson H, Kanis JA, Oden A, Johnell O, McCloskey E. BMD, clinical risk factors and their combination for hip fracture prevention. Osteoporos Int 2009; 20(10): 1675–82.

8. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 2000; 15(4): 721–39.

9. Omsland TK, Emaus N, Tell GS, et al. Ten-year risk of second hip fracture. A NOREPOS study. Bone 2013; 52(1): 493–7.

10. Vochteloo AJ, Borger van der Burg BL, Roling MA, et al. Contralateral hip fractures and other osteoporosis–related fractures in hip fracture patients: incidence and risk factors. An observational cohort study of 1,229 patients. Arch Orthop Trauma Surg 2012; 132(8): 1191–7.

11. Skála–Rosenbaum J, Dzupa V, Bartoška R, Říha D, Waldauf P, Bača V. Subsequent contralateral hip fractures: can at-risk patients be identified? An observational study of 5,102 patients. Int Orthop 2015 ; 39(4): 755–60.

12. Berry SD, Samelson EJ, Hannan MT, et al. Second hip fracture in older men and women: the Framingham Study. Arch Intern Med 2007; 167(18): 1971–6.

13. Papaioannou A, Wiktorowicz M, Adachi JD, Goeree R, Papadimitropoulos E. Mortality, independence in living, and re-fracture, one year following hip fracture in Canadians. J Soc Obstet Gynaecol Can 2000; 22: 591–7.

14. von Friesendorff M, Besjakov J, Akesson K. Long-term survival and fracture risk after hip fracture: a 22-year follow-up in women. J Bone Miner Res 2008; 23(11): 1832–41.

15. Ryg J, Rejnmark L, Overgaard S, Brixen K, Vestergaard P. Hip fracture patients at risk of second hip fracture: a nationwide population–based cohort study of 169,145 cases during 1977–2001. J Bone Miner Res 2009; 24(7): 1299–307.

16. Papaioannou A, Kennedy CC, Ioannidis G, et al. The osteoporosis care gap in men with fragility fractures: the Canadian Multicentre Osteoporosis Study. Osteoporos Int 2008; 19(4): 581–7.

17. Roerholt C, Eiken P, Abrahamsen B. Initiation of anti-osteoporotic therapy in patients with recent fractures: a nationwide analysis of prescription rates and persistence. Osteoporos Int 2009; 20(2): 299–307.

18. Solomon DH, Johnston SS, Boytsov NN, McMorrow D, Lane JM, Krohn KD. Osteoporosis Medication Use after Hip Fracture in U.S. Patients between 2002 and 2011. J Bone Miner Res 2014; 29(9): 1929–37.

19. Kim SC, Kim MS, Sanfelix-Gimeno G, et al. Use of osteoporosis medications after hospitalization for hip fracture: a cross–national study. Am J Med 2015; 128(5): 519–26.

20. Lyles KW, Colon-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 2007; 357(18): 1799–809.

21. Misof BM, Fratzl-Zelman N, Paschalis EP, Roschger P, Klaushofer K. Long–term safety of antiresorptive treatment: bone ma­te­rial, matrix and mineralization aspects. BoneKEy Rep 2015; 4: 634.

22. Reid IR. Efficacy, effectiveness and side effects of medications used to prevent fractures. J Intern Med 2015; 277(6): 690–706.

23. WHO. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. Geneva: World Health Organisation; 1994.

24. Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR. Risk of Subsequent Fractures and Mortality in Elderly Women and Men With Fragility Fractures With and Without Osteoporotic Bone Density: The Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 2015; 30(4): 637–46.

25. Nguyen TV, Center JR, Eisman JA. Femoral neck bone loss predicts fracture risk independent of baseline BMD. J Bone Miner Res 2005; 20(7): 1195–201.

26. Leslie WD, Majumdar SR, Morin SN, Lix LM. Why does rate of bone density loss not predict fracture risk? J Clin Endocrinol Metab 2015; 100(2): 679–83.

27. Langsetmo L, Goltzman D, Kovacs CS, et al. Repeat low–trauma fractures occur frequently among men and women who have osteopenic BMD. J Bone Miner Res 2009; 24(9): 1515–22.

28. Siris ES, Miller PD, Barrett Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001; 286(22): 2815–22.

29. WHO. Assessment of osteoporosis at the primary health care level. Report of a WHO Study Group. Sheffield: University of Sheffield Medical School, UK; 2007.

30. Leslie WD, Lix LM. Comparison between various fracture risk assessment tools. Osteoporos Int 2014; 25(1): 1–21.

31. Bauer DC, Garnero P, Harrison SL, et al. Biochemical markers of bone turnover, hip bone loss, and fracture in older men: the MrOS study. J Bone Miner Res 2009; 24(12): 2032–8.

32. Rizzoli R, Ammann P, Chevalley T, Bonjour JP. Protein intake and bone disorders in the elderly. Joint Bone Spine 2001; 68(5): 383–92.

33. Schurch MA, Rizzoli R, Slosman D, Vadas L, Vergnaud P, Bonjour JP. Protein supplements increase serum insulin–like growth factor–I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1998; 128(10): 801–9.

34. Murad MH, Drake MT, Mullan RJ, et al. Comparative Effectiveness of Drug Treatments to Prevent Fragility Fractures: A Systematic Review and Network Meta-Analysis. J Clin Endocrinol Metab 2012; 97: 1871–80.

35. Reid IR, Bolland MJ. Calcium risk-benefit updated-new WHI analyses. Maturitas 2014; 77(1): 1–3.

36. Adami S, Giannini S, Bianchi G, et al. Vitamin D status and response to treatment in post–menopausal osteoporosis. Osteoporos Int 2009; 20(2): 239–44.

37. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 2001; 22(4): 477–501.

38. Bischoff–Ferrari HA, Can U, Staehelin HB, et al. Severe vitamin D deficiency in Swiss hip fracture patients. Bone 2008; 42(3): 597–602.

39. LeBoff MS, Hawkes WG, Glowacki J, Yu–Yahiro J, Hurwitz S, Magaziner J. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008; 19(9): 1283–90.

40. Bischoff–Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson–Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005; 293(18): 2257–64.

41. Sawka AM, Ismaila N, Cranney A, et al. A scoping review of strategies for the prevention of hip fracture in elderly nursing home residents. PLoS ONE 2010; 5(3): e9515.

42. Avenell A, Gillespie WJ, Gillespie LD, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev 2009(2): CD000227.

43. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007; 370(9588): 657–66.

44. Grant AM, Avenell A, Campbell MK, et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo–controlled trial. Lancet 2005; 365(9471): 1621–8.

45. Bischoff–Ferrari HA, Willett WC, Wong JB, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta–analysis of randomized controlled trials. Arch Intern Med 2009; 169(6): 551–61.

46. Prestwood KM, Pannullo AM, Kenny AM, Pilbeam CC, Raisz LG. The effect of a short course of calcium and vitamin D on bone turnover in older women. Osteoporos Int 1996; 6(4): 314–9.

47. Boonen S, Lips P, Bouillon R, Bischoff–Ferrari HA, Vanderschueren D, Haentjens P. Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 2007; 92(4): 1415–23.

48. Harwood RH, Sahota O, Gaynor K, Masud T, Hosking DJ. A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Age Ageing 2004; 33(1): 45–51.

49. Bischoff Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005; 293(18): 2257–64.

50. van Groningen L, Opdenoordt S, van Sorge A, Telting D, Giesen A, de Boer H. Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur J Endocrinol 2010; 162(4): 805–11.

51. Rosa J. Doporučené postupy pro diagnostiku a terapii postmenopauzální osteoporózy II. Osteologický Bull 2007; 12(2): 74–81.

52. Ensrud KE, Black DM, Palermo L, et al. Treatment with alendronate prevents fractures in women at highest risk: results from the Fracture Intervention Trial. Arch Intern Med 1997; 157(22): 2617–24.

53. McClung MR, Geusens P, Miller PD, et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 2001; 344(5): 333–40.

54. Osaki M, Tatsuki K, Hashikawa T, et al. Beneficial effect of risedronate for preventing recurrent hip fracture in the elderly Japanese women. Osteoporos Int 2012; 23(2): 695–703.

55. Boonen S, Black DM, Colon–Emeric CS, et al. Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older. J Am Geriatr Soc 2010; 58(2): 292–9.

56. Thompson K, Rogers MJ. Statins prevent bisphosphonate-induced gamma,delta-T-cell proliferation and activation in vitro. J Bone Miner Res 2004; 19(2): 278–88.

57. Shane E, Burr D, Abrahamsen B, et al. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American society for bone and mineral research. J Bone Miner Res 2014; 29(1): 1–23.

58. Khan AA, Morrison A, Hanley DA, et al. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015; 30(1): 3–23.

59. Boonen S, Adachi JD, Man Z, et al. Treatment with denosumab reduces the incidence of new vertebral and hip fractures in postmenopausal women at high risk. J Clin Endocrinol Metab 2011; 96(6): 1727–36.

60. Reginster JY, Seeman E, De Vernejoul MC, et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin Endocrinol Metab 2005; 90(5): 2816–22.

61. Jonville–Bera AP, Autret–Leca E. [Adverse drug reactions of strontium ranelate (Protelos((R)) in France]. Presse Med 2011; 40(10): e453–62.

62. Eriksen EF, Keaveny TM, Gallagher ER, Krege JH. Literature review: The effects of teriparatide therapy at the hip in patients with osteoporosis. Bone 2014; 67: 246–56.

63. Aspenberg P, Genant HK, Johansson T, et al. Teriparatide for acceleration of fracture repair in humans: a prospective, randomized, double-blind study of 102 postmenopausal women with distal radial fractures. J Bone Miner Res 2010; 25(2): 404–14.

64. Walsh JB, Lems WF, Karras D, et al. Effectiveness of Teriparatide in Women Over 75 Years of Age with Severe Osteoporosis: 36–Month Results from the European Forsteo Observational Study (EFOS). Calcif Tissue Int 2012; 90(5): 373–83.

65. Nikolaou VS, Efstathopoulos N, Kontakis G, Kanakaris NK, Giannoudis PV. The influence of osteoporosis in femoral fracture healing time. Injury 2009; 40(6): 663–8.

66. Gorter EA, Hamdy NA, Appelman-Dijkstra NM, Schipper IB. The role of vitamin D in human fracture healing: a systematic review of the literature. Bone 2014; 64: 288–97.

67. Gong HS, Song CH, Lee YH, Rhee SH, Lee HJ, Baek GH. Early initiation of bisphosphonate does not affect healing and outcomes of volar plate fixation of osteoporotic distal radial fractures. J Bone Joint Surg Am 2012; 94(19): 1729–36.

68. Adami S, Libanati C, Boonen S, et al. Denosumab treatment in postmenopausal women with osteoporosis does not interfere with fracture-healing: results from the FREEDOM trial. J Bone Joint Surg Am 2012; 94(23): 2113–9.

69. Gerstenfeld LC, Sacks DJ, Pelis M, et al. Comparison of effects of the bisphosphonate alendronate versus the RANKL inhibitor denosumab on murine fracture healing. J Bone Miner Res 2009; 24(2): 196–208.

70. Larsson S, Fazzalari NL. Anti–osteoporosis therapy and fracture healing. Arch Orthop Trauma Surg 2014; 134(2): 291–7.

71. Aspenberg P, Johansson T. Teriparatide improves early callus formation in distal radial fractures. Acta Orthop 2010; 81(2): 234–236.

72. Zhang D, Potty A, Vyas P, Lane J. The Role of Recombinant Pth in Human Fracture Healing: A Systematic Review. J Orthop Trauma 2014; 28(1): 57–62.

73. Ellegaard M, Kringelbach T, Syberg S, et al. The effect of PTH(1–34) on fracture healing during different loading conditions. J Bone Miner Res 2013; 28(10): 2145–55.

74. Peichl P, Holzer LA, Maier R, Holzer G. Parathyroid hormone 1–84 accelerates fracture-healing in pubic bones of elderly osteoporotic women. J Bone Joint Surg Am 2011; 93: 1583–7.

75. Vaculík J, Dungl P, Malkus T, et al. Péče o pacienty se zlomeninou horního konce stehenní kosti. I. Ortopedická péče. Doporučené postupy České revmatologické společnosti a Společnosti pro metabolická onemocnění skeletu. Čes Revmatologie 2009; 17(3): 134–44.

76. Langdahl BL, Rajzbaum G, Jakob F, et al. Reduction in fracture rate and back pain and increased quality of life in postmenopausal women treated with teriparatide: 18-month data from the European Forsteo Observational Study (EFOS). Calcif Tissue Int 2009; 85(6): 484–93.

77. Eriksen EF, Lyles KW, Colon–Emeric CS, et al. Antifracture efficacy and reduction of mortality in relation to timing of the first dose of zoledronic acid after hip fracture. J Bone Miner Res 2009; 24(7): 1308–13.

78. Siris ES, Harris ST, Rosen CJ, et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 2006; 81(8): 1013–22.

79. Ganda K, Schaffer A, Seibel MJ. Predictors of re-fracture amongst patients managed within a secondary fracture prevention program: a 7-year prospective study. Osteoporos Int 2015; 26(2): 543–51.

80. Eisenberg DF, Placzek H, Gu T, Krishna A, Tulsi BB. Cost and consequences of noncompliance to oral bisphosphonate treatment. Journal of managed care & specialty pharmacy 2015; 21(1): 56–65.

81. LeBlanc ES, Rosales AG, Balasubramanian A, et al. Risk factors for fracture among current, persistent users of bisphosphonates. Osteoporos Int 2015; 26(2): 713–25.

82. Kannus P, Parkkari J, Niemi S, et al. Prevention of hip fracture in elderly people with use of a hip protector. N Engl J Med 2000; 343(21): 1506–13.

83. Kiel DP, Magaziner J, Zimmerman S, et al. Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA 2007; 298(4): 413–22.

84. Cryer C, Knox A, Stevenson E. Factors associated with hip protector adherence among older people in residential care. Inj Prev 2008; 14(1): 24–9.

85. Oliver D, Connelly JB, Victor CR, et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ 2007; 334(7584): 82.

86. Cameron ID, Kurrle S, Quine S, et al. Increasing adherence with the use of hip protectors for older people living in the community. Osteoporos Int 2011; 22(2): 617–26.

87. Close JC. How can you prevent falls and subsequent fractures? Best Pract Res Clin Rheumatol 2013; 27(6): 821–34.

88. Cumming RG, Thomas M, Szonyi G, et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc 1999; 47(12): 1397–402.

89. Madureira MM, Takayama L, Gallinaro AL, Caparbo VF, Costa RA, Pereira RM. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int 2007; 18(4): 419–25.

90. Robertson MC, Devlin N, Gardner MM, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial. BMJ 2001; 322(7288): 697–701.

91. Singh NA, Quine S, Clemson LM, et al. Effects of high-intensity progressive resistance training and targeted multidisciplinary treatment of frailty on mortality and nursing home admissions after hip fracture: a randomized controlled trial. J Am Med Dir Assoc 2012; 13(1): 24–30.

92. Duque G, Troen BR. Understanding the mechanisms of senile osteoporosis: new facts for a major geriatric syndrome. J Am Geriatr Soc 2008; 56(5): 935–41.

93. Myint MW, Wu J, Wong E, et al. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial. Age Ageing 2013; 42(1): 39–45.

94. Wyers CE, Reijven PL, Evers SM, et al. Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial. Osteoporos Int 2013; 24(1): 151–62.

95. Richy F, Dukas L, Schacht E. Differential effects of D-hormone analogs and native vitamin D on the risk of falls: a comparative meta-analysis. Calcif Tissue Int 2008; 82(2): 102–7.

96. Solomon DH, Finkelstein JS, Katz JN, Mogun H, Avorn J. Underuse of osteoporosis medications in elderly patients with fractures. Am J Med 2003; 115(5): 398–400.

97. Andrade SE, Majumdar SR, Chan KA, et al. Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 2003; 163(17): 2052–7.

98. Vytřísalová M, Fuksa L, Palička V, et al. Adherence to osteoporosis guideline: survey among Czech general practitioners. Cent Eur J Med 2014; 9(5): 687–93.

99. McLellan AR, Wolowacz SE, Zimovetz EA, et al. Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int 2011; 22(7): 2083–98.

100. Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007; 356(18): 1809–22.

101. Boonen S, Marin F, Mellstrom D, et al. Safety and efficacy of teriparatide in elderly women with established osteoporosis: bone anabolic therapy from a geriatric perspective. J Am Geriatr Soc 2006; 54(5): 782–9.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#