Bone Abstracts

Background: Osteoporotic fractures are a major cause of disability and results in extensive utilization of health care resources. The history of previous fractures increases the risk for future fragility fractures.

Subject: To describe the diagnostic therapeutic protocol of our tertiary care clinic dedicated to the osteoporosis (OP) treatment. To estimate the use of effective therapies for OP in those patients at highest risk for future fracture.

Methods: Patients with a history of OP or with high risk of fracture (calculated using DEFRA or frax) were preliminarily assessed by general practitioners and/or by rheumatologist at a primary level clinic or at bone densitometry service. In presence of a suspected fracture patients were referred to our tertiary center.

If not available second level laboratory evaluation, bone densitometry and morphometry X-ray of the spine had been performed. We adopted SIOMMMS guidelines for treatment of osteoporosis.

Results: We analyzed data from 300 consecutive patients who received OP consultations for fragility fractures at our referral centre from December 2011 to December 2013. The consultation included an extensive risk factor analysis for OP.

In this time lapse overall 49 patients were suitable to start teriparatide (16.3%). Of these, primary osteoporosis was diagnosed in 24 patients and secondary osteoporosis in 25. Median age was of 75 years (range 53–84) and ratio of women to men was 7/1 (43 females, and 6 males). 46 patients have started treatment with teriparatide: among them, three discontinued treatment for adverse events. A follow-up of 12 months was available for 18 patients: no patient had new fractures during this period.

Conclusion: Sharing of diagnostic and therapeutic pathways allows to identify patients at increased risk for fragility fractures in order to offer them the best available treatment and to provide monitoring throughout the follow-up.