Optimizing osteoporosis management: targeting to treat — an initiative by the Egyptian Academy of Bone Health

Abstract

The overarching goal of treating osteoporotic patients is to reduce the incidence of fractures, yet interventions that support early detection of osteoporosis and prevention of osteoporotic fractures are underutilized. Osteoporosis and, specifically, the associated burden of fractures call for a screening strategy offering an opportunity to intervene early. Such strategy should be clinically feasible and cost-effective, aiming to identify and treat subjects at high or very high risk of fragility fracture. The low sensitivity of bone mineral density measurements in identifying high-risk patients is evidenced by the high number of osteoporotic fractures occurring in subjects with BMD values above threshold required for a diagnosis of osteoporosis. Consequently, DXA scanning is not considered appropriate as a public screening tool identifying patients at risk of sustaining fragility fractures and current efforts focus on identifying non-BMD-related risk factors. In Egypt, we are fortunate in having all modalities of osteoporosis therapy and assessment tools available, yet there remains a significant treatment gap in osteoporosis management. Furthermore, screening for fracture risk is not currently advocated nationally. This manuscript describes a national initiative for a population screening intervention to identify patients at risk of developing a fragility fracture aiming to reduce fragility fractures especially in older adults.