BARCELONA, Spain—European doctors are less likely to screen for or treat osteoporosis than clinicians in North American and Australia, perhaps resulting in higher hip fracture rates in Europe, according to baseline data from the ongoing Global Longitudinal registry of Osteoporosis in Women (GLOW). The study will monitor for 5 years the health of >60,000 women worldwide aged ≥55. The results were presented at the 35th European Symposium on Calcified Tissues in Barcelona, Spain.1

"This is a chance to look at real women in real practices and follow them to determine who they are, what their risk factors are, what their outcomes are, and whether they are being appropriately managed."—Ethel S. Siris, MD
"Some countries do a better job than others, and there may be differences within the US as well," said GLOW researcher Ethel S. Siris, MD, the Madeline C. Stabile professor of clinical medicine and director of the Toni Stabile osteoporosis center at Columbia University Medical Center in New York City. "The fact that there is less screening and treatment in Europe is a function of health care, how seriously they take osteoporosis, and it may also be a function of risk factors which may also vary [by country]."

In the large-scale epidemiological study, one in four women from Europe, North America, and Australia reported having ≥1 fractures since the age of 45. Just 26% of high-risk women reported use of bone-saving drugs such as bishosphonates, raloxifene, strontium ranelate, parathyroid hormone, teriparatide, tibolone, and calcitonin. Use was significantly less frequent in Europe than in North America and Australia, GLOW data showed.

Among women considered to be at high risk of fracture, only 20% of European women were taking a bone medication versus 30% of North American/Australian women. Current use of an osteoporosis medication increased with age across the globe: 24% of those participants aged ≥75 took medication compared with 12% <65 years. Use also increased with clinical risk with 26% of women with Fracture Index scores ≥5 (indicating 5-year risk of nonvertebral fracture of 26%) reported taking bone-related medication.

Moreover, fractures after the age of 45 were more common in Europe than in the United States, Canada, and Australia. For hip fracture specifically, a prior hip fracture was reported more frequently by women in Europe (2.1%) than by women in the United States (1.7%) or Canada/Australia (1.4%). In Europe, 51% of GLOW participants reported having a bone density test. Testing was more frequent in other countries.

Translating GLOW Research into Practice

"GLOW offers some really interesting data on real world practice," Dr. Siris told MSKreport.com. "This is a chance to look at real women in real practices and follow them to determine who they are, what their risk factors are, what their outcomes are, and whether they are being appropriately managed. GLOW takes advantage of having the opportunity to look at women who are not part of a clinical trial."

Reference

1. Diez-Perez A, Adami S, Boonen S, et al. Regional differences in the management of osteoporosis: Europe vs other geographic regions. The Global Longitudinal registry of Osteoporosis in Women. Presented at: 35th European Symposium on Calcified Tissues. May 24-28, 2008; Barcelona, Spain. Poster Su-P337.