ACR: Osteoporosis Underdiagnosed, Undertreated in Older Men

TUESDAY, Nov. 17, 2020 — In the older male population, there is a high level of underdiagnosis and undertreatment of osteoporosis, according to a study presented at ACR Convergence, the annual meeting of the American College of Rheumatology, held virtually from Nov. 5 to 9.

Setareh A. Williams, Ph.D., from Radius Health Inc. in Waltham, Massachusetts, and colleagues examined the characteristics of 9,876 Medicare fee-for-service beneficiaries with a closed fragility or osteoporosis-related fracture between Jan. 1, 2010, and Sept. 30, 2014.

The researchers found that 61 percent of the patients were aged 75 years or older. In the two years prior to their fracture, fewer than 6 percent had undergone bone mineral density testing with dual-energy X-ray absorptiometry (DXA). One year prior to index fracture, 62.8 percent had a history of musculoskeletal pain and 48.5 percent had a history of opioid use. The spine, hip, and ankle were the most commonly observed fracture sites (31.0, 27.9, and 9.8 percent, respectively). About 92.8 percent of patients with a qualifying fracture did not have a claim for diagnosis or treatment of osteoporosis at baseline; 2.8, 2.3, and 2.1 percent were diagnosed but not treated, treated but not diagnosed, and diagnosed and treated, respectively. From 2012 to 2014, there was a trend seen for declining DXA scans (65 to 69 years, 6.3 to 5.5 percent; 70 to 74 years, 4.7 to 4.0 percent; 75 years and older, 6.0 to 4.3 percent).

“Men are typically not part of routinely recommended screening with DXA and so they are both underdiagnosed and undertreated,” a coauthor said in a statement.

Several authors disclosed financial ties to the biopharmaceutical industry.

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