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01-02-2019 | LETTER TO THE EDITOR

Correspondence in response to OSIN-D-18-00831 quantifying imminent risk

Authors: J.A. Kanis, H. Johansson, N.C. Harvey, M. Lorentzon, E. Liu, F. Borgström, E.V. McCloskey

Published in: Osteoporosis International | Issue 2/2019

Excerpt

We thank Drs. Geusens and van den Bergh for their interest in our paper. We agree that quantifying imminent risk is an important next step. However, there are several factors that need to be considered that impact on such a development, including the following:

The recency of a sentinel fracture. As we report [1], the magnitude of “imminent” risk reduces with time, and thus the timing of the index fracture prior to assessment, be it one day, one week or one year, is critical.
The age at fracture. A prior fracture history is a significant risk factor for fracture at all ages, but the relative risk is highest at younger ages and decreases progressively with age [2].
Age dependency of imminent risk. A recent population-based study showed that the phenomenon of immediate risk was also age-dependent, the transient effect being more evident at older ages [3].
The site of sentinel fracture [1].
Sex. The difference in risk is greater for men than for women for all ages [1]
The non-linear mortality following a hip or vertebral fracture [4, 5].

…

Kanis JA, Johansson H, Odén A, Harvey NC, Gudnason V, Sanders K, Sigurdsson G, Siggeirsdottir K, Borgström F, McCloskey EV (2018) Characteristics of recurrent fractures. Osteoporos Int 29:1747–1757CrossRefPubMedPubMedCentral

Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton IIILJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed

Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E, Sigurdsson G, Kanis JA (2017) Imminent risk of fracture after fracture. Osteoporos Int 28:775–780CrossRefPubMed

Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK (2003) The components of excess mortality after hip fracture. Bone 32:468–473CrossRefPubMed

Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B (2004) Excess mortality after hospitalisation for vertebral fractures. Osteoporos Int 15:108–112CrossRefPubMed

Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl D, Cyrus Cooper C, on behalf of the IOF Working Group on Epidemiology and Quality of Life (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256CrossRefPubMedPubMedCentral

Kanis JA, on behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield. Accessed https://www.shef.ac.uk/FRAX/reference.aspx 2 October 2018

Kanis JA, Harvey NC, Cooper C, Johansson H, Odén A, McCloskey EV (2016) A systematic review of intervention thresholds based on FRAX. Arch Osteoporos 11:25CrossRefPubMedPubMedCentral

National Institute for Health and Care Excellence (2017) TA 464: Bisphosphonates for treating osteoporosis. Technology appraisal guidance 464. National Institute for Health and Care Excellence, London. nice.org.uk/guidance/ta464

10.

National Institute for Health and Care Excellence (2012) CG146: osteoporosis: fragility fracture risk. Short clinical guideline- evidence and recommendation, National Clinical Guideline Centre, London

11.

Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2018) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. https://doi.org/10.1007/s00198-018-4704-5

12.

Committee for Medicinal Products for Human Use (CHMP) (2006) Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. CHMP, London

Title: Correspondence in response to OSIN-D-18-00831 quantifying imminent risk
Authors: J.A. Kanis
H. Johansson
N.C. Harvey
M. Lorentzon
E. Liu
F. Borgström
E.V. McCloskey
Publication date: 01-02-2019
Publisher: Springer London
Published in: Osteoporosis International / Issue 2/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-018-4796-y

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