(078) Lifetime risk of fracture among postmenopausal women with osteoporosis and at high risk of fracture

Background: Data from countries in the European Union (EU) show that the lifetime risk of fracture ranges between 43-78%, but recent data from the United States (US) is lacking.

Objectives: The aim of this study was to assess the cumulative lifetime risk of fractures among post-menopausal women with osteoporosis aged ≥50 years of age in the US.

Methods: We followed a retrospective cohort of high-risk postmenopausal women with osteoporosis, aged ≥50 years using Optum Clinformatics® Data Mart, covering individuals who were privately insured or possessed employer-sponsored Medicare Advantage plans, from Jan 1, 2021 (index date) until the earliest of: 1) osteoporotic fracture, 2) death, 3) disenrollment, or 4) end of the study period (Dec 31, 2021) to assess the 1-year incidence of osteoporotic fractures after index date. High risk of fracture was defined as a history of fracture at any time prior to index date or by the presence of ≥2 risk factors among the following: a) age ≥65 years, b) history of smoking or alcohol use, d) type 2 diabetes mellitus, e) oral steroid use, f) rheumatoid arthritis, and g) immobilization. The following osteoporotic fractures were included: hip/femur, pelvis, lower leg and ankle, forearm, upper arm, and vertebral fractures, identified using ICD-10 and procedure codes. We used the current probability method, which uses the incidence of fractures by age strata, population estimates for each age and all-cause mortality incidence to estimate the lifetime risk of fracture.

Results: A total of 1,275,854 women were included in the study, with a mean (SD) age of 75.6 (8.9) years. Using the current probability method, the 1-year incidence of fractures increased by age, from 0.9% in women aged 50-54 to 9.7% in women aged ≥90 years. The lifetime risk of fracture among women with osteoporosis aged ≥50 and at high risk of fracture was 79.2%. This risk was 76.3% for women aged ≥55 years and 72.1% for women aged ≥60 years.

Conclusions: Among over one million, high-risk postmenopausal women with osteoporosis, more than 2 out of 3 will experience a fracture at least once in their remaining lifetime. This data highlights the importance of appropriate screening, diagnosis, and management of osteoporosis in this high-risk patient population.