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Sansum Clinic Participates in Landmark Study on Osteoporosis

Findings highlight the need for public education about risk factors and treatment

Nearly 3,000 Sansum Clinic patients are participating in the Global Longitudinal Study of Osteoporosis in Women (GLOW) that has underscored what researchers call a serious international public health concern: Women at an elevated level of risk for osteoporosis-associated fractures do not perceive themselves as being at higher risk for fracture than their age-matched peers.

This latest study from GLOW, based at the Center for Outcomes Research at the University of Massachusetts Medical School, was published this week in the journal Osteoporosis International and included more than 60,000 postmenopausal women.

The findings showed that among postmenopausal women from 10 countries in Europe, North America and Australia diagnosed with osteoporosis — a condition putting them at high risk for fractures — only 43 percent thought their risk of a fracture was higher than that of other women their age. Additionally, only one in three (33 percent) women in GLOW who reported two or more major risk factors for fracture perceived themselves as being at higher risk for fracture than their age-matched peers.

Dr. Stuart Silverman, a clinical professor of medicine at the UCLA School of Medicine and the medical director of the Osteoporosis Medical Center in Beverly Hills, is a member of the scientific advisory board for this landmark international study and the GLOW investigator for Southern California. Silverman brought Sansum Clinic into the study because he recognized the strengths of its clinical research department.

Of the 28,000 U.S. women enrolled in GLOW, 2,957 are from Sansum Clinic. A fifth (20 percent) of women participating reported an osteoporosis diagnosis, 18 percent had a previous fracture, 15 percent were low weight, 39 percent reported recent falls and 18 percent a parental hip fracture. Despite the high prevalence of risk factors, only 32 percent of women with two or more major risk factors perceived themselves to be at higher risk of a fracture than their peers. This failure by women to appreciate their personal risk of fracture presents a barrier to them receiving appropriate management and safe and effective treatments.

“Research has always been an important part of Sansum Clinic, and we have had incredibly positive feedback from our patients participating in this study,” said Dr. Kurt Ransohoff, Sansum’s president and CEO. “Many members of our community have or are at risk of developing osteoporosis, and we are proud of our part in advancing the findings that will help protect them from injury.”

One in two women will suffer an osteoporosis-related fracture after age 50; these fractures often carry with them chronic pain, reduced mobility, loss of independence, and especially in the case of hip fracture, an increased risk of death. Because the likelihood of fractures increases substantially with older age, fracture numbers are projected to rise as the population ages. Osteoporosis-related fractures are an international public health problem; in addition to the human suffering, they are also the source of enormous health-care costs.

Improved education of both physicians and postmenopausal women about osteoporosis risk factors is urgently needed, according to the study authors. Osteoporosis causes bones to become fragile and therefore more likely to break. If left untreated, the disease can progress painlessly until a fracture occurs.

Several risk factors for fractures have been identified and should be considered by physicians treating women age 55 or older:

» older age

» low weight

» parental hip fracture

» personal history of fracture (clavicle, arm, wrist, spine, rib, hip, pelvis, upper leg, lower leg, ankle) since age 45

» two or more falls in the past year

» current use of cortisone or prednisone (steroids often prescribed for a number of medical conditions)

» rheumatoid arthritis

» cigarette smoking

» consumption of three or more alcoholic beverages daily

Other risk factors include a variety of medical conditions and medications. Although tools for diagnosis and risk assessment, including bone density testing and the World Health Organization FRAX fracture risk assessment tool, are widely available, the connection between identified risk factors and serious fracture outcomes is not being made by a majority of women who are at the highest risk. Since many fractures can be prevented by appropriate treatment, it is important that elevated risk be recognized.

“We hope the insight we obtain from GLOW will help physicians and patients work together to both identify those at risk for fracture and to enhance understanding of the meaning of that risk,” said the lead author of the paper, Dr. Ethel Siris. “Education is critical if we are to reduce the burden of fractures worldwide.”

— Linda Chapman is a clinic researcher for Sansum Clinic.

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