Osteoporosis in the European Union: medical management, epidemiology and economic burden

Abstract

Summary This report describes the epidemiology, burden, and treatment of osteoporosis in the 27 countries of the European Union (EU27). Introduction Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures which represent the main clinical consequence of the disease. Fragility fractures are associated with substantial pain and suffering, disability and even death for affected patients and substantial costs to society. The aim of this report was to characterize the burden of osteoporosis in the EU27 in 2010 and beyond. Methods The literature on fracture incidence and costs of fractures in the EU27 was reviewed and incorporated into a model estimating the clinical and economic burden of osteoporotic fractures in 2010.Results Twenty-two million women and 5.5 million men were estimated to have osteoporosis; and 3.5 million new fragility fractures were sustained, comprising 610,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures). The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Incident fractures represented 66 % of this cost, long-term fracture care 29 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining.

MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

“…These include a balanced diet rich in dairy, ensuring an adequate calcium (1000 mg/day) and vitamin D (1000 IU/day) intake, regular weight-bearing exercise (40 min walk 3!/week), limiting alcohol to !3 units per day, stopping smoking, the avoidance of other bone toxins and the prevention of falls (121). In children and adolescents, physical activity is the best way to build up bone mass and strength.…”

Augmentation of Musculoskeletal Regeneration: Role for Pluripotent Stem Cells

“…Osteoporosis (OP) is a prevalent osteodegenerative disease, with an estimated 22 million women, and 5.5 million men being affected within the EU [19]. Worldwide, it is estimated that OP results in over 8.9 million fractures annually (Table 1) [20].…”

“…It has been shown that a combination of these had a synergistic effect on BMD [22]. While these treatments have been suggested to slow the progression of OP, they fail to offer long-term effective solutions [19] and are associated with multiple severe side effects [23,24], and patients are typically subjected to lifelong administration.…”

High Frequency of Fractures in an Early Stage of MS

“…A history of a fragility fracture or fractures is predictive of future fractures [3]. Fragility fractures are associated with significant pain, suffering, disability and considerable costs to society [4].…”

“…Osteoporosis is defined as a generalised skeletal decrease in bone mineral density (BMD) and is an independent predictor of fragility fractures [4]. In patients with MS, reduced BMD [5], as well as an increased risk of falling [6], may increase the risk of fragility fractures, even in patients younger than 50 years old.…”