The International Osteoporosis Foundation (IOF) has welcomed the recently published paper European guidance for the diagnosis and management of osteoporosis in postmenopausal women(1) from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
This paper constitutes a roadmap for European countries to practically implement the new FRAX™ tool based on the WHO technical report, Assessment of osteoporosis at the primary health care level(2,3). The European guidance, published in Osteoporosis International, is a critical review of diagnostic methods, treatments and their monitoring options. It also shows case-finding strategies supported by health economic data.
IOF sees the ESCEO guidance as a positive move towards using the FRAX™ algorithm in daily practice. The WHO report and FRAX™ tool, released on February 21, 2008, help health practitioners to better understand the new paradigm for diagnosis and management of people at risk of developing fragility fractures.
In this regard, there will be a FRAX™ exhibition booth at the forthcoming ECCEO 8 Congress in Istanbul, Turkey, to be held at the Grand Cevahir Hotel & Convention Center. Participants will have the opportunity to have their 10-year fracture risk calculated, based on their geographic origin and individual risk factors. As a next step, the ESCEO paper can contribute with guidance on how to manage or monitor their condition, in the most rationale and cost-effective way.
Professor Jean-Yves Reginster, President of ESCEO, noted, “The ESCEO European guidance is convergent with the WHO report on how to assess and treat postmenopausal women with or at risk from osteoporosis. Moreover, cost-effectiveness analyses which illustrate scenarios based on a UK setting provide a starting point for health policy makers and health care providers to develop national guidelines on diagnosis and intervention thresholds.”
The ESCEO guidance is very timely, as across Europe, osteoporosis is a major public health problem with serious medical and economic impact. In 2000, throughout the region, there were an estimated 620,000 new hip fractures, 574,000 forearm fractures, 250,000 shoulder fractures, and 620,000 spinal fractures in men and women aged 50 years or over, accounting for 34.8% of such fractures worldwide(4). There are more than 2.7 million osteoporotic fractures in men and women in Europe at a direct cost of 36 billion euros(5). It is estimated that by 2050, direct costs related to hip fractures will increase to 76.7 billion euros(6).