Conclusions All interventions produced positive effects on BMD scanning and osteoporosis treatment rates post-fracture .
Despite sizeable increases , investigation and treatment rates remain sub-optimal .
Background There is a large quality of care gap for patients with osteoporosis .
As a fragility fracture is a strong indicator of underlying osteoporosis , it offers an ideal opportunity to initiate investigation and treatment .
However , studies of post-fracture population s document screening and treatment rates below 20 % in most setting s. This is despite the fact that bone mineral density ( BMD ) scans are effective at identifying patients at high risk of fracture , and effective drug treatments are widely available .
Effective interventions are required to remedy this incongruity in current practice .
Effect of intermittent cyclical etidronate therapy on bone mass and fracture rate in women with postmenopausal osteoporosis.
Progressive bone loss in osteoporosis results from bone resorption in excess of bone formation . We conducted a double-blind study in 66 women with postmenopausal osteoporosis of therapy with etidronate , a diphosphonate compound that reduces bone resorption by inhibiting osteoclastic activity . The patients were r and omly assigned in equal numbers to receive oral etidronate ( 400 mg per day ) or placebo for 2 weeks , followed by a 13-week period in which no drugs were given . This sequence was repeated 10 times , for a total of 150 weeks . Daily oral supplementation with calcium and vitamin D was given throughout the study to both groups . Vertebral bone mineral content was measured by dual-photon absorptiometry ; spinal radiographs were assessed to identify new vertebral fractures . Vertebral bone mineral content increased significantly ( P less than 0.01 ) after 150 weeks of etidronate therapy ( 5.3 percent ; 95 percent confidence interval , 2.0 to 8.6 ; n = 20 ) but decreased with placebo ( -2.7 percent ; 95 percent confidence interval , -7.3 to 1.9 ; n = 20 ) . The difference between groups was 8.0 percentage points ( P less than 0.01 ; 95 percent confidence interval , 2.4 to 13.6 ) . The rates of fracture were significantly different for the period from week 60 to week 150 between the etidronate and placebo groups ( 6 vs. 54 fractures per 100 patient-years ; P = 0.023 ) . No adverse clinical , biochemical , or bone histomorphometric effects of treatment were observed . We conclude that at the end of nearly three years , etidronate therapy for postmenopausal osteoporosis results in significant increases in vertebral bone mineral content and , after approximately one year of treatment , a significant decrease in the rate of new vertebral fractures
Conclusions All interventions produced positive effects on BMD scanning and osteoporosis treatment rates post-fracture .
Despite sizeable increases , investigation and treatment rates remain sub-optimal .
Background There is a large quality of care gap for patients with osteoporosis .
As a fragility fracture is a strong indicator of underlying osteoporosis , it offers an ideal opportunity to initiate investigation and treatment .
However , studies of post-fracture population s document screening and treatment rates below 20 % in most setting s. This is despite the fact that bone mineral density ( BMD ) scans are effective at identifying patients at high risk of fracture , and effective drug treatments are widely available .
Effective interventions are required to remedy this incongruity in current practice .