Why is osteoporosis important?
Osteoporosis has been defined as a ‘progressive systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk’.1 However, because microarchitectural deterioration of bone tissue cannot be measured clinically, the description of osteoporosis based on T-score has been accepted as the clinical definition.
The World Health Organization defines osteoporosis as a T-score value for bone mineral density (BMD), measured by dual-energy X-ray absorptiometry (DXA) at the femoral neck, of ≥2.5 standard deviations below the young adult female mean (T-score ≤–2.5).2 Using this definition, it is estimated that 5.2% of the UK population (approximately 3 755 000 people) are affected.3 The clinical significance of osteoporosis is fragility fracture, of which there are 527 000 annually in the UK, projected to rise to 665 000 annually by 2034.3 Fragility fractures impact on individuals and may lead to pain, disability, and reduced quality of life. Osteoporotic fragility fractures are associated with reduced relative survival and, at 12 months post-hip fracture, mortality in the UK is approximately 28%.4,5 Fragility fractures also impose a significant economic burden on the NHS, costing the UK c. £4.5 billion annually, representing approximately 2.4% of total healthcare expenditure.3
This clinical practice article provides general practice teams with guidance on fracture risk assessment and osteoporosis drug management informed by the latest evidence, the current authors’ experience and expertise, and the National Institute for Health and Care Excellence (NICE)-accredited 2021 National Osteoporosis Guideline Group …
