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Osteoporosis: the silent disease

Osteoporosis: the silent disease

Osteoporosis, which means porous bones, is a disease in which bones become brittle and so are more likely to break. To mark World Osteoporosis Day on 20 October, we look at 'the silent disease', its burden on the individual and on society, and the problem of patients not adhering to their treatment.

Osteoporosis is a disease in which the density and quality of bone are reduced, leading to deterioration of the skeleton and increased risk of fracture. It's often diagnosed only after an osteoporosis-related fracture happens because the patient has no outward signs or symptoms.

The disease has a significant impact on patients' quality of life and it is estimated that one in three women and one in five men over the age of 50 will develop osteoporosis during their lifetimes.

The silent nature of the disease – the lack of symptoms – means many patients do not continue their treatment. Why take medication if there are no apparent signs of the disease? In this way, patients are putting themselves at increased risk of fracture by failing to adhere to their medication.

Treatments for osteoporosis

Better bone health

Tips in the battle against osteoporosis include:

Daily recommended amounts
of calcium and vitamin D
Avoiding smoking and excessive alcohol
Taking your medication
Exercise

There is currently no cure for osteoporosis, but treatments can strengthen bones and help reduce the risk of fractures.

Bisphosphonates are a common treatment. These inhibit bone resorption (bone break down), but one problem is the strict dosing regime needed for effective absorption of the medication. This may be a contributing factor why, after one year, about half of patients stop taking their treatment. These therapies are available as daily, weekly and – more recently – monthly oral therapies.

Over two-thirds of patients on a daily treatment are likely to have stopped taking their therapy after two years, joining those patients missing out on the benefits that these drugs can provide over time. Clinical studies have shown that patients taking their medication less frequently – weekly and/or monthly – adhere longer to their medication.

Adhering to medical treatments is ‘a worldwide problem of striking magnitude’, according to the World Health Organization. It is estimated that only half the number of people with chronic diseases adhere to their treatment and one in five don’t even bother to take out their prescriptions.

There is currently no cure for osteoporosis,
but treatments can strengthen bones and help reduce the risk of fractures

Individual burden of osteoporosis

If osteoporosis patients do not stay on their therapy, they may significantly increase their chance of suffering a fracture. About 25-30 per cent of patients who suffer a hip fracture die within a year.

The lack of mobility resulting from a fracture can lead to social isolation and loneliness, depression and an increased dependency on others. Many limitations are put on patients with severe osteoporosis, not only by their pain but also by the fear of more fractures – the risk of new fractures is markedly increased once they start having them.

There are constant reminders of the limitations that the disease places on them and how their everyday quality of life is affected.

Society's burden
It’s not only the individual that suffers – osteoporosis fractures have a major impact on society and healthcare systems. The worldwide cost burden of osteoporosis is forecast to increase to a minimum of £70 billion by 2050.

While the cost of osteoporosis-related fractures worldwide is high, the true cost is thought to be higher because large numbers of people with osteoporosis are not diagnosed.

Osteoporosis prevalence

The prevalence of osteoporosis is growing as the number of post-menopausal women rises, along with the general increase in life expectancy. Other statistics include:

Osteoporosis affects an estimated 75 million people in Europe, the US and Japan
A third of post-menopausal women and one in five men over the age of 50 are affected by osteoporosis
In women over 45, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, heart attack and breast cancer

The reason why
How can osteoporosis and other patients be encouraged to stay on their treatment?

It is understood that the development of drugs with few side effects and simple dosing help patients to stay on therapy. Across a range of therapeutic areas, it has been found that adherence to medications is inversely related to the frequency of dosing.

Healthcare professionals can help patients stay on therapy and it is known that accommodating patients’ preferences when selecting treatment improves adherence levels.

It is also believed that people with chronic diseases such as osteoporosis can work together to improve therapy adherence. In the case of osteoporosis, many member societies of the International Osteoporosis Foundation operate helpful support groups.

Recognition for GSK
Earlier this year, the International Osteoporosis Foundation (IOF) recognised GlaxoSmithKline for ‘outstanding leadership’ by encouraging employees to practice good bone health.

GSK was one of six companies to be recognised for its efforts by adopting the IOF’s Corporate Responsibility Program for Bone Health – a programme regarded by GSK as an important opportunity to raise awareness of osteoporosis and to support employees in taking steps to protect their bone health.

Reference source: International Osteoporosis Foundation