OP0032 GENDER DISPARITIES IN OSTEOPOROSIS DIAGNOSIS AND MANAGEMENT AMONG PATIENTS WITH VERTEBRAL FRACTURES: INSIGHTS FROM A LARGE-SCALE DATABASE STUDY (2024)

Abstract

Background: Vertebral fractures are the most common of all osteoporotic fractures, the risk of which increases with age. Bone density begins to decrease after age 40, with more decline in postmenopausal women. Caucasian women are particularly at increased risk. Whether symptomatic or asymptomatic, vertebral fracture can affect patients’ health and quality of life. A bone density scan is important for diagnosing underlying osteoporosis, which increases the risk of recurrent fractures.

Objectives: In our observational, retrospective cohort study, we aimed to compare the rates of osteoporosis diagnosis, bone density scans, and treatment between male and female cohorts with vertebral fractures but no prior osteoporosis diagnosis. This study was conducted using the TriNetX database, which encompasses electronic health records from >80 diverse global healthcare organizations.

Methods: Two cohorts were established using the TriNetX database: women (Cohort 1) and men (Cohort 2). We included patients aged 55 years and above in both groups. The index event was the initial appearance of a vertebral fracture diagnosis, using the International Classification of Diseases, Tenth Revision (ICD-10) codes. We excluded patients who had osteoporosis fractures prior to the vertebral fracture. Propensity score matching was employed for age and race/ethnicity. Our outcome of interest included osteoporosis diagnosis, the occurrence of bone density scans, and osteoporosis treatment within three years of the index event (vertebral fracture). The studied osteoporosis treatments included bisphosphonates, denosumab, romosozumab, teriparatide, abaloparatide, and raloxifene. We used measures of association to calculate the risk and risk ratio showing the difference in the occurrence of outcomes in patients with vertebral fracture.

Results: The analysis involved 194,638 women and 112,067 men with vertebral fractures. The age at the time of vertebral fracture was slightly different between the two cohorts. Both groups consisted primarily of a white population. After propensity score matching, 108,718 patients from each group were included in the analysis. 20.128% of women (compared to 10.538% of men) were diagnosed with osteoporosis within 3 years of vertebral fracture diagnosis, with a risk difference of 9.59% and a risk ratio of 1.91 (95% CI: 1.862, 1.96; P < 0.0001).[Figure 1] Bone density scans were conducted in 0.029% of women and 0.009% of men, with a risk ratio of 3.102 (95% CI: 1.521, 6.326; P value 0.0010). The low number of bone density scans is explained by the fact that some of the healthcare organizations participating with TriNetX don’t report diagnostic tests. Regarding treatment, 13.998% of women and 8.222% of men received osteoporosis treatment, with a risk difference of 5.776% (P < 0.0001), a risk ratio of 1.702 (95% CI 1.659, 1.747), and the odds ratio was 1.817, favoring women.[Figure 2]

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.