IWO bijeenkomst - 14 november - J.P. van den Bergh

Joop van den Bergh
ASBMR 2018 highlights
Adapted from:
ASBMR 2018 slideset

Relations that could be relevant for the
meeting
Company name
 Research funds
 Speaker board / consultancy / travel
 Stakeholder
 Stock or other…
 Amgen, Eli Lilly, Novo Nordisk
 Amgen, Eli Lilly, UCB, Sanofi
• -
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Disclosure of speaker’s interests

Montreal
The ASBMR Program for 2018
• Meet The Professors (12 clinical,10 basic translational)
• Working Groups (5)
• Oral abstracts 157 (12% of total 1304, = 2017)
• Late-breaking abstracts 118 (+28% over 2017)
• 2018: Total (not including late breaking abstracts) = 1304 (+5.6%)
• 2 Dutch Young investigator awards

#1023: Abrahamsen, Skjodt, Vesteragaard. Hip fracture rates and time
trends in use of anti-osteoporosis medications in Denmark for the period
2005-2015
Background: The “treatment gap” has been based upon declining
bisphosphonate use in the outpatient setting.
Question: Would the treatment gap be different if ALL anti-osteoporotic
meds were compared with hip fracture rates over the same period?
Methods: National data base: hip Fxs and total use of all medicines. # of Fx
prevented due to drugs assumed to be 0.3 hip Fxs per 100 person years
(from FIT without Fx).

#1023: Abrahamsen, Skjodt, Vesteragaard. Hip fracture rates and time trends
in use of anti-osteoporosis medications in Denmark for the period 2005-2015
Hip fractures sustained
Hip fractures prevented‘14
Results: Hip Fxs declined
by 30%; med use peaked in
‘14. Only 10% of the hip Fx
decline could be attributed to
medication use.

0905: Treatments for Osteoporosis Do Not Reduce Overall Mortality
Steven Cummings, Li-Yung Lui, Douglas C. Bauer, Dennis M. Black
• Included placebo-controlled trials with at least 50 participants in the placebo
group and at least one death
• Trials with secondary causes, such as corticosteroid use, were excluded.
• Estrogen therapy and strontium were not included
• With and without Selective estrogen receptor modulators (SERMs) and
tibolone: no dfifference outcome
• If there was more than one type of treatment, each treatment arm was
compared to the placebo group.

Poster photo
With permission first author

Young investigator awards
Thomas Merlijn Frans Heyer

#1025: Thomas Merlijn*, Swart, Netelenbos, Elders. Screening of High
Fracture Risk in Primary Care Not Effective
Background: Identifying women for treatment after a fracture event is reactive
Question: Can a proactive screening program to identify women who meet criteria
for treatment reduce fractures?
Methods: Women (65-90) with at least 1 CRF (previous fracture, parental hip
fracture, low body weight, secondary causes for osteoporosis) were either evaluated
(BMD, VFA, and FRAX) or assigned to ‘usual care.’
Rx given if indicated. Follow up: 3.7 yrs.
Results: Active screening and subsequent Rx had no effect on time to first Fx, nor
first hip Fx.
*Young investigator award

#1231 Late breaking: Thomas Merlijn, Swart, Netelenbos, Elders.
A systematic review and meta-analysis of ROSE, SCOOP and Salt (SOS) studies
All three studies:
• primary care population
• women (mean age 70-75),
• high fracture risk
• Based on questionnaire
followed by BMD in the
women with increased
risk
• Small differences in risk
selection and treatment
thresholds, but all studies used
FRAX in risk selection or in
treatment thresholds.
• In all studies there was dilution:
in the intervention group 13-25%
had a treatment indication and
11-17% started anti-osteoporotic
drugs.

Frans Heyer. The Effect of Vitamin D3 Supplementation on Distal Radius Fracture
Healing: A Randomized Controlled HR-pQCT Trial
Background:
Question: To asses the effect of vitamin D3 (cholecalciferol) supplementation on HR-
pQCT/μFEA-based outcome measures in distal radius fracture healing.
Methods: 3 month follow-up after fracture
• Control group (no supplementation)
• Low-dose group: 30.000 IU cholecalciferol/6 weeks (equivalent to 700 IU/day)
• High-dose group: 75.000 IU cholecalciferol/6 weeks (equivalent to 1800 IU/day)

Frans Heyer. The Effect of Vitamin D3 Supplementation on Distal Radius Fracture
Healing: A Randomized Controlled HR-pQCT Trial
• 700 IU/day does not accelerate or enhance fracture healing
• 1800 IU/day may be detrimental in restoring bone stiffness by increasing
bone resorption during the first 12 weeks of fracture healing

#1146: Leslie, Morin, Lix, McCloskey, Johansson, Harvey, Kanis. Fracture
Risk Assessment in Women with Breast Cancer Initiating Aromatase Inhibitor
Therapy
Background: Aromatase Inhibitor Rx for breast cancer is reported to be
associated with bone loss and increased fracture risk.
Question: Can FRAX be used to predict fracture risk in a population of women
> 40?
Methods:
• Breast cancer with >12 months of AI use (n=1775)
• Breast cancer without AI use (n=1016)
• No breast cancer (n=34,205)
Manitoba

CumulativeFractureIncidence
With competing mortality risk. AI use as “secondary osteoporosis”
Major osteoporotic fractures, log-rank p=0.148
Years
0 2 4 6 8 10
Cumulativeincidencefraction
0.00
0.05
0.10
0.15
0.20
General population
Breast cancer, aromatase inhibitor users
Breast cancer, aromatase inhibitor non-users
AI use
Top curves;
no AI use or
no cancer
#1146: Leslie, Morin, Lix, McCloskey, Johansson, Harvey, Kanis. Fracture
Risk Assessment in Women with Breast Cancer Initiating Aromatase Inhibitor
(AI)Therapy
Results:
Adjusted for FRAX with BMD

#1146: Leslie, Morin, Lix, McCloskey, Johansson, Harvey, Kanis. Fracture Risk
Assessment in Women with Breast Cancer Initiating Aromatase Inhibitor
(AI)Therapy
Conclusion: The data challenge the view that women initiating AI
Rx are at high fracture risk.
Comments:
• The conclusion may be based upon differences at baseline in
that AI users had higher BMI, higher BMD, lower osteoporosis
prevalence, and fewer fractures.
• There is no mention of whether AI users were treated
prophylactically with anti-osteoporosis medications.

#1143: Wallander, Axelsson, Lundh, Lorentzon. Patients with prostate cancer
(PC) and androgen deprivation therapy (ADT) have increased risk of fractures.
Background: ADT in men with PC is associated with increased risk of fractures. Most
studies, however, are small.
Question: Can a large database confirm this impression?
Methods: Swedish registry of 179,744 men (age 79) with PC and ADT (6954) or
without ADT (13128). Follow up: 270,300 patient years.
Results:
ADT use: greater risk of any Fx, hip Fx, and MOF.
PC without ADT use: no increase.
Conclusion: In this high risk group therapeutic intervention to prevent fractures on ADT
therapy is appropriate
With PC
+ ADT

#1143: Wallander, Axelsson, Lundh, Lorentzon. Patients with prostate cancer
(PC) and androgen deprivation therapy (ADT) have increased risk of fractures.
With PC
+ ADT
Time to hipfracture Time to major osteoporootic fracture
Osteoporos Int 2018 online 15-10-18

The Greater the Number of Prevalent Vertebral Fractures
(VFs),the Greater the Risk of Future VFs
14
12
10
8
6
4
0
2
IncidenceofNewVFat1Year(%)
0 1 ≥ 2≥ 1
Number of VFs at Baseline
Women with an
incident VF
had a 19% risk of
new VF within 1
year
Lindsay R, et al JAMA. 2001;285(3):320-323.
One year data in 2725 women randomized to placebo

#1112: Schousboe, Lix, Morin, Bryanton, Alhrbi, Leslie. Prevalent Vertebral
Fracture Identified on Densitometric Images Predict Incident Fractures in
Routine Clinical Practice.
Background: The predictive value of VFA in clinical practice has not been
established.
Design: Manitoba BMD database (‘10- ); Definite VFs identified in 15.8% of 9972
men and women (age 76). Incident fxs identified from administrative claims database
over 2.8 yrs.

#1026: Schousboe, Lix, Morin, Derkatch, Bryanton, Alhrbi, Leslie. Identification
of Prevalent Vertebral Fracture Increases Utilization of Pharmacologic Fracture
Prevention Therapy
Conclusion: Even among those whose
fracture risk is high (either by T-score or
prevalent vert Fx), when a fracture is
documented by VFA, use of
osteoporosis medication increases
(OR 2.37 after adjustments for other
fracture risk assessments.)
Proportion treated
VFA+
VFA-
0
0.1
0.2
0.3
0.4
0.5
0.6
0 90 180 270 360
Cumulativeproportiontreated
Days after VFA
VFA
VFA +
VFA-
Proportion treated

#1058: Bauer, Vittinghoff, Black, Bouxsein, Cauley, de Papp, Grauer, Khosla, Mitlak,
McCulloch, Eastell. Change in Bone Turnover as a Surrogate Marker for Fracture
Outcome
#1070: Black, Vittinghoff, Eastell, Bauer, Lui, Palermo, McCulloch, Cauley, Khosla,
Marin, de Papp, Grauer, Bouxsein. Change in BMD as a Surrogate for Fracture Risk
Reduction in Osteoporosis Trials.
Background: FNIH Bone Quality Project seeks to identify a surrogate that can be used
in place of fracture in future clinical trials.
Questions: Are treatment-related changes in bone turnover markers (BTMs) and/or
bone mineral density (BMD) by DXA attractive candidates?
Design: A “mother-of-all” data collection studies! Combined and pooled data from 14
antiresorptive (BTMs) and 25 antiresorptive and anabolic (BMD) RCTs: > 100,000
subjects

#1058: Change in Bone
Turnover as a Surrogate
Marker for Fracture
Outcome (shaded, P
<0.05)
#1070: Change in BMD
as a Surrogate for
Fracture Risk Reduction
in Osteoporosis Trials.
(for all, P < 0.05)
Percent of Treatment Effect
Bone ALP PINP sCTX
Vertebral
(13 trials)
127% (86, 167%) 72% (29, 115%) 65% (32, 98%)
Non-vert
(15 trials)
117% (24, 209%) 130% (29, 231%) 87% (13,161%)
Hip(15 trials) 71% (-37, 178%) 150% (6, 294%) 27%(-70, 124%)

#1058: Change in Bone Turnover as a Surrogate Marker for Fracture Outcome
#1070: Change in BMD as a Surrogate for Fracture Risk Reduction in
Osteoporosis Trials.
Conclusions and Comment:
• Proof of Concept
• Analytical and statistical challenges
• Both BMD and BTMs (BMD>BTMs) explain a substantial percentage of treatment
effect for Vert and Non-vert (BMD and BTMS) and for Hip (BMD) fractures
• What is the clinical applicability to an individual patient, given that the study
“required” over 100,000 individuals to demonstrate these relationships?

Treat to target:
Relationship Between Total Hip T-score and Nonvertebral Fracture

#1074: Cosman, Lewiecki, Ebeling, Hesse, Napoli, Crittenden, Rojeski, Yang,
Libanati, Ferrari. T-score as an Indicator of Fracture Risk on Therapy.
Evidence from the Romosozumab v Alendronate Treatment in the ARCH Trial.
Question: Does improvement in T-score result in lower
fracture risk; does it depend upon the treatment received or
the T-score achieved?
Design: ARCH: 12 months 12 months
Alendronate
(n=2047)
Romosozumab
(n=2048)
Alendronate
Alendronate

#1074: Cosman, Lewiecki, Ebeling, Hesse, Napoli, Crittenden, Rojeski, Yang,
Libanati, Ferrari. T-score as an Indicator of Fracture Risk on Therapy.
Evidence from the Romosozumab v Alendronate Treatment in the ARCH Trial.
Results: TH T-score achieved after year
two correlated with the non-vert Fx rate
in the open label period, independent of
the drug.
Improvement in T-score
Romo (+0.31) ALN (+0.15)
Romo arm was associated with the
greater reduction in non-vert Fx rate.
Conclusion: Support for the treatment
to target concept.
Expected1-YearNonvertebralFracture
IncidenceinOpen-LabelPeriod(%)
Relationship was independent of treatment, age
strata, BMD, and severity of fracture at baseline
Nonvertebral Fracture

#1073: Leder, Lee, David, Eastell, Tsai. Rapid and Large BMD Increases in PM Women
Treated with Combined High-Dose teriparatide and Denosumab.
#1059: Tsai, Yuan, David, Lee, Bouxsein, Leder. Effect of Denosumab and High-Dose
Teriparatide on Peripheral Bone Mineral Density and Microarchitecture.
Background: DATA study: Combined Teriparatide and Dmab gives greater
increases in BMD and improved microstructure in comparison to either
drug alone. BTMs are compatible with a wider anabolic window.
Questions: Can a higher dose teriparatide (40 ug ) lead to an even wider
anabolic window than the 20 ug dose?
Design: 69 PM women, 15 months. Teriparatide 20 vs 40 ug given from
T=0 to nine months: Denosumab 60 mg SC in both groups at months
three, nine, and 15.

#1073: Leder et al Rapid and Large
BMD Increases in PM Women Treated
with Combined High-Dose teriparatide
and Denosumab
• Results: Higher dose of teriparatide
gives greater increases in BMD at
spine and TH.
#1059: Tsai et al Effect of Denosumab
and High-Dose Teriparatide on
Peripheral Bone Mineral Density and
Microarchitecture.
• Results: Higher dose of teriparatide
gives greater increases in Tibial Total
vBMD and radial Ct.vBMD.

“Anabolic
window”
An Expanded Anabolic Window: the Model
Months
IndexofBoneTurnover
Peak
Bone Formation
Bone Resorption

LB-1166: Fracture Prevention in Osteopenic Postmenopausal Women
with Zoledronic Acid Every 18 Months, a Randomized Controlled Trial
• 6-year, double-blind trial
• 2000 women with osteopenia (T score of −1.0 to −2.5)
• 71 years
• Vitamin D 100.000, followed by 50.000/ month; no calcium supplements
• Median Hip FRAX: 2.3%. four infusions zoledronate 5 mg or normal saline
(placebo group) at 18-month intervals
This article was published on October 1, 2018, at NEJM.org

Osteoporosis: Adverse Effects Of Therapeutics

#1007: Black, Geiger, Li, Ryan, Dell, Adams. Bisphosphonate Use and Risk
of AFF Varies by Pre-treatment BMD level.
Background: AFF is associated with duration of
BP therapy.
Question: Does PreRx BMD alter this
relationship?
Design: 152,934 women with preRx BMD and BP
use. 185 cases of AFF adjudicated by two experts
using ASBMR criteria.
Results: Higher PreRx BMD associated with
higher AFF Risk. Time-dependence not influenced
by PreRx BMD
Bars: T-scores
Open: >-1.0
Middle: >-.2.5, < -1.0
Filled: < -2.5

#1005: Adams, Li, Ryan, Geiger, Dell, Black.
Do Drug Holidays Reduce Atypical Femur Fracture Risk?
Background: AFF is associated with duration of BP therapy.
Question: Is risk of AFF reduced after stopping BP Rx?
Design: 152,934 women with preRx BMD and BP use. 185 cases of AFF adjudicated
by two experts using ASBMR criteria.
Results: Stopping BP Rx is associated with a marked and progressive reduction in
AFF risk.
Years after DC % Reduction RR (CIs)
1 year 44% 0.56 (0.38-0.82)
1-4 years 80% 0.20 (0.10-0.37)
> 4 years 78% 0.22 (0.08-0.59)

#1006: Curtis, Chen, Li, Arora, Saag, Wright, Daigle, Kligore, Delzell.
The Impact of Bisphosphonate Drug Holidays on Fracture Rates.
Background: The incidence of osteoporotic Fxs after the drug holiday is not known.
Question: After three to five years of BP
Rx, is stoppage associated with an
increased in Fx risk?
Design: Medicare database (160,369);
36% drug holiday > 12 months (w/o any
follow up Rx). Mean follow up: 2.7 years.
Compared to continuous BP use.
Results: Drug Holiday > two years is
associated with increased risk of hip
(and humerus) Fx as compared to those who continue BP therapy

#1062: Burt, Rose, Emma O. Billington*, Raymond, Hanley, Boyd.
The Calgary Vitamin D Study: Bone Microstructure Effects of 3-yr
Supplementation with 400, 4,000, or 10,000 IU Daily.
Background: Daily doses > 4,000 IU of vitamin D are not recommended (IOM)
Question: Are doses > 4,000 IU/day beneficial by DXA or HRpQCT and FEA
measurements?
Design: 311 healthy men and women with T-scores >-2.5. Baseline 25-OH D 12-50
ng/mL (20-125 nmol/l). Followed for three years.
Results: 25-OH increased to 75 (400 IU); 115 (4,000) and 188 (10,000) nmol/L; No
benefits re DXA or HRpQCT (small reductions) or failure load.
* Most outstanding abstract in Nutrition Research: in Memory of Robert Heaney

#1062: Burt, Rose, Emma O. Billington, Raymond, Hanley, Boyd. The Calgary
Vitamin D Study: Bone Microstructure Effects of 3-yr Supplementation with
400, 4,000, or 10,000 IU Daily.
Comment: Is this a reiteration of the Heaney principle on threshold nutrients?
Intake 
Effect

No further
benefit

#1116: Daniel Dudenkov, Mara, Petterson, Maxson, Thacher.
Serum 25-Hydroxyvitamin D and Risk of Incident Cardiovascular Disease.
Background: Too little and too much vitamin D are both said to be bad for you (the
“inverted J-shaped curve”).
Question: Are values < or > recommended range for 25-OH (50-125 nmol/L)
associated with cardiovascular endpoints?
Design: 11,022 individuals (54 year olds) who had 25-OH levels measured over a
seven-year period. Mean follow 4.8 yrs. Usual CV events defined and recorded.
Results: Average 25-OH D, 75 nmol/L: Relative to range 50-125 nmol/L
• RR risk:
– < 30 nmol/L 1.33 (CI 1.17-1.51)
– 30-50 nmol/L: 1.22 (CI 1.12-1.33)
– >125 nmol/L: 1.15-1.31 (CI 1.00-1.31)

#1116: Daniel Dudenkov, Mara, Petterson, Maxson, Thacher. Serum 25-
Hydroxyvitamin D Values and Risk of Incident Cardiovascular Disease.
Worse Not Worse
AnyCVEvent
Continues the discussion about whether 25-OH
levels > 50 ng/mL (125 nmol/l) include risks

#1040: Harvey, Oden, Orwoll, Kwok, Karlsson, Rosengren, Ribom, Cawthon,
Ensrud, Cooper, Kanis, Ohlsson, Mellstrom, Johansson, McCloskey. Definitions of
Sarcopenia as Predictors of Fracture Risk Independent of FRAX, falls, and BMD. A
Meta-analysis of MrOS
Background: Predictive value of sarcopenia for incident fractures
Question: Will sarcopenia lose its predictive value if fnBMD, FRAX, prior falls are
taken into effect, across most definitions of sarcopenia?
Design: MrOS (Sweden, USA, Hong Kong). Seven definitions of sarcopenia utilized.
Results: All definitions of sarcopenia (except Studenski) were associated with incident
MOF.
Adjustments: FRAX and prior falls: slight attenuations:
FN BMD alone, however, led to marked attenuation of the relationship to borderline
significance.

Conclusion:
Sarcopenia, as generally defined, does not predict Fx when fnBMD is taken into
account.
Other muscle measures, besides those traditionally associated with the definition of
sarcopenia, might help to better establish the relationship between sarcopenia and
skeletal mass.
#1040: Harvey, Oden, Orwoll, Kwok, Karlsson, Rosengren, Ribom, Cawthon,
Ensrud, Cooper, Kanis, Ohlsson, Mellstrom, Johansson, McCloskey. Definitions of
Sarcopenia as Predictors of Fracture Risk Independent of FRAX, falls, and BMD. A
Meta-analysis of MrOS

#1041: Cawthon, Peters, Cummings, Orwoll, Hoffman, Ensrud, Cauley,
Evans. Muscle Mass Assessed by D3Cr (deuterated creatine) Dilution and
Incident Fractures in Older Men
The D3Cr dilution method:
• participant ingesting a 30-mg dose of stable isotope-labeled creatine (D3-
creatine)
• fasting, morning urine sample 72–144 hours (3–6 days) later in which D3-
creatinine, unlabeled creatinine, and creatine
• these measures are then included in an algorithm to determine total body
creatine pool size and thus skeletal muscle mass

Gerontol A Biol Sci Med Sci, 2018, Vol. XX

#1041: Cawthon, Peters, Cummings, Orwoll, Hoffman, Ensrud, Cauley,
Evans. Muscle Mass Assessed by D3Cr (deuterated creatine) Dilution and
Incident Fractures in Older Men
Background: Measurements of muscle mass, including ALM/ht2 and whole
body measurements, are dependent on DXA and, thus, do not directly
measure muscle mass. Deuterated creatine (D3Cr), a measure of muscle
mass, is associated with injurious falls and worse physical performance.
Hypothesis: Reduced muscle mass by D3Cr is a risk factor for fracture while
ALM/ht2 is not.
Design: 1388 men (age 84) in year 14 of MrOS. 2.4 years of follow-up.
Adjustments for age, fnBMD, FRAX (with BMD).

#1041: Cawthon, Peters, Cummings, Orwoll, Hoffman, Ensrud, Cauley, Evans.
Muscle Mass Assessed by D3Cr (deuterated creatine) Dilution and Incident
Fractures in Older Men
Results: Each SD decrement in D3Cr muscle mass/wgt associated with a 23-25% increased risk of CF or
Non-Vert Fx and 72% increase in risk of hip Fx. ALM/ht2 was not
Conclusion: D3Cr may be a novel risk factor for fracture in older men.
DXA
D3Cr

#1060: Daly, Duckham, Tait, Rantalainen, Nowson, Taaffe, Cowan, Hill,
Buxija, Sanders. Effect of Dual-Task Functional Power and Mobility Training
on Falls and Physical Function in Older People Living in Retirement Villages.
Background: Falls are more likely to occur in older people when they are performing
attention-demanding cognitive or motor tasks (i.e. when they are distracted!)
Question: Can dual task training (power training and simultaneous cognitive or motor
task) reduce falls?
Design: 77 year olds (n=300) in retirement villages randomized to training or usual
care; six months of training and six months follow up.
Results: Good news: mobility and muscle power increased and multiple (but not
single) falls were reduced
Bad news: ATTRITION: 50 TO 60%

Clinical Applications of Advanced Imaging*

#1109: Samuelson, Dermissie, Adachi, 26 more authors and Kiel. Deficits in
Cortical and Trabecular Bone Microarchitecture Increase Short-term Risk of
Fracture Independently of DXA BMD and FRAX.
Background: There is a need to identify individuals at imminent risk of fracture.
Question: Can HRpQCT indices predict fracture risk over two years?
Design: Seven Cohorts, prospective; 6,763 subjects. Mean age 68; 71% women;
8% FN T-score < -2.5; 55% -1.0 to -2.5; 37% > -1.0.
Results: All cortical indices (except porosity) and all trabecular indices at radius and
tibia showed HRs > 1.0 with or without adjustment for DXA Fn or FRAX for MOF.
Failure load also significantly predictive.

#1111: Chapurlat, Sornay-Rendu, Zebaze, Bui, Lespessailles, Seeman.
Deterioration of Bone Microstructure Identifies Women at Imminent Risk of
Fragility Fracture.
Background: There is a need to identify individuals at imminent risk of
fracture.
Question: Can HRpQCT indices predict fracture risk over 2 years?
Design: Two Cohorts, prospective; 1,996 women (age 67). BMD, FRAX, and
Structural Fragility Score (SFS)- cortical porosity/trabecular density index
relative to premenopausal controls
Results: 98 had a fracture after mean of 1.06 years.

#1111: Chapurlat, Sornay-Rendu, Zebaze, Bui, Lespessailles, Seeman.
Deterioration of Bone Microstructure Identifies Women at Imminent Risk of
Fragility Fracture.
Results: Neither BMD nor FRAX was predictive.
SFS > 70: 14/20 identified when BMD < -2.5 (OR: 3.95)
29/78 identified when BMD ‘osteopenic’ (OR: 3.01)
19/24 women > 70 with MOF (OR: 8.52)
Conclusion: Most women at imminent risk for fracture (i.e. within two
years) cannot be identified by BMD or FRAX but can be identified by
identifying microstructural deterioration.

#1038: Morin, Yan, Lix, Leslie. Changes in the Risk of Subsequent Major
Osteoporotic Fractures over Time in Men and Women: A Population-Based
Observational Study with 25-year follow up.
Background: A fracture begets a fracture and begets another fracture
Question: Over an extended 25-year period of observation, does fracture
risk remain elevated after the fracture?
Methods: Administrative Canadian healthcare database; 17,721 men;
57,783 women > 50 who sustained an index MOF ‘89-’06.

#1038: Morin, Yan, Lix, Leslie. Changes in the Risk of Subsequent Major
Osteoporotic Fractures over Time in Men and Women: A Population-Based
Observational Study with 25-year follow up.
Results: Risk over 15
years was sustained over
historical controls with risk
in men>women for all ages
except > 80. Risk was
higher and attenuated
more so in men.

IWO bijeenkomst - 14 november - J.P. van den Bergh

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IWO bijeenkomst - 14 november - J.P. van den Bergh