The risk of a patient experiencing a second major osteoporotic fracture is greatest straight after having suffered an initial break, according to researchers.
They said their results suggested that pharmacological treatment for secondary fracture prevention may be most usefully initiated immediately following a first fracture.
“The risk of further fracture after a first major osteoporotic fracture is greatest immediately following the first event”
The research team set out to determine whether the predictive value of a past major osteoporotic fracture for a future one changed with time.
They studied a database of 118,872 men and women born between 1907 and 1935 who were part of the Reykjavik Study during 1967-1991. Data on all fractures from participant entry into the study until 31 December 2012 were extracted.
Of the 5,039 patients who experienced one or more major osteoporotic fractures and were included in the analysis, 1,919 patients experienced a second fracture.
The analysis showed the risk of a second major osteoporotic fracture after a first increased by 4% for each year of age and was 41% higher for women than men.
In addition, the risk of a second major osteoporotic fracture was greatest immediately after the first fracture. Although the risk thereafter decreased with time, it remained higher than the population risk throughout follow-up.
One year after the first major osteoporotic fracture the risk of a second fracture was three times higher than that risk among those who had not experienced a fracture.
After 10 years the risk was still elevated – at two times the risk in the non-fracture population, but was lower than at one year.
Professor Nicholas Harvey, from the MRC Lifecourse Epidemiology Unit at the University of Southampton, presented the preliminary results from study at a conference at the weekend.
He stated: “The results of our study show that the risk of further fracture after a first major osteoporotic fracture is greatest immediately following the first event, with a declining, but still increased, risk in subsequent years.
Vitamin D supplements during pregnancy questioned
“These results suggest that pharmacological treatment for secondary fracture prevention should be considered during the period immediately following a first fracture,” he added.
The results of the new study appear to support international efforts to promote secondary fracture prevention.
Studies have shown that half of all patients who experience a hip fracture have previously been treated for a fragility fracture but all too often without proper diagnosis of the underlying cause.
It is estimated that approximately 80% of patients who suffer a first fracture are never diagnosed and treated.
Their findings were presented at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases in Malaga in Spain and published in a supplement of the journal Osteoporosis International.