Post-Fracture Care Program: Pharmacological Treatment of Osteoporosis in Older Adults with Fragility Fractures.
Yasser El MiedanyMathias TothWalaa ElwakilSally SaberPublished in: Current osteoporosis reports (2023)
A comprehensive management approach is required to reduce mortality and morbidity associated with fragility fractures. This will help to reduce the risk of missing the diagnosis of osteoporosis as the underlying disorder while at the same time promoting the timely treatment of osteoporosis. The target is to minimize the incidence of post-traumatic disability and to reduce the imminent fracture risk. This article will present a Bone-Care algorithm for the diagnosis and management of fragility fractures in patients presenting for trauma surgery. This algorithm has been developed based on recently published national as well as international guidelines for implementation in standard clinical practice. International figures revealed that only a small proportion of those patients at high risk of sustaining a fragility fracture receive osteoporosis therapy. Based on the best currently available evidence, it is safe to start osteoporosis therapy in the acute post-fracture period (the optimal therapeutic window of romosozumab is the late endochondral phase/throughout bone remodeling). The right Bone-Care pathway ensures the delivery of a comprehensive management approach that meets the global call to action. All parameters including risk, benefit, compliance, and cost should be considered on an individual base for all kinds of therapy.
Keyphrases
- bone mineral density
- postmenopausal women
- quality improvement
- healthcare
- body composition
- clinical practice
- palliative care
- machine learning
- end stage renal disease
- hip fracture
- chronic kidney disease
- affordable care act
- risk factors
- liver failure
- physical activity
- deep learning
- newly diagnosed
- pain management
- intensive care unit
- ejection fraction
- type diabetes
- randomized controlled trial
- coronary artery disease
- prognostic factors
- bone regeneration
- stem cells
- single cell
- cardiovascular disease
- acute coronary syndrome
- cell therapy
- extracorporeal membrane oxygenation
- respiratory failure
- acute respiratory distress syndrome
- bone marrow