4.4 million Italians with osteoporosis are at risk of fractures, few treatments

With the progressive aging of the Italian population, preserving the independence and active lifestyles of the population has turned into a challenge that research, innovation, social initiatives and health policy can help address. In particular, fragility fractures – 568 thousand new cases in 2019 in Italy – represent a serious obstacle to aging in good health, compromising the independence and quality of life of approximately 4,400,000 people (80% women and 20% men ) who in our country suffer from osteoporosis, the main cause of fragility fractures. This is what emerges from the data of the second edition of ‘Scope’ 21 ‘, an epidemiological study carried out by the International Osteoporosis Foundation (Iof), which takes stock of osteoporosis in Europe (27 countries plus the United Kingdom and Switzerland), with an detailed analysis of our country. The study shows that clinicians today have effective pharmacological treatments available, but this aspect has long been neglected, despite the huge economic burden on health care linked to osteoporosis. We are talking, in fact, of 9.5 billion euros spent in Italy in 2019, of which 5.44 billion for the direct costs of fragility fractures, 3.75 billion for those of long-term disability and 259 million for pharmacological interventions. . “For people who have suffered a fragility fracture, the risk of suffering a second one is 5 times higher than for those who have not suffered this event – declares Maria Luisa Brandi, president of the Fragility Fracture Observatory (Off) – Despite the adoption of adequate therapy would be able to reduce this risk by 65%, in reality the problem of undertreatment is worrying. “The ‘Scope’ 21 ‘Report suggests, in fact, that in Italy 2 million and 900 thousand women should be subjected to a treatment for osteoporosis, but 71% of them do not receive any drug treatment. “This huge therapeutic gap does not only concern our country, but is observed throughout Europe, demonstrating the low importance given to fragility fractures up to to date – adds Brandi -. Since the incidence of these fractures in Italy is expected to increase by 23.4% by 2034, the time has come to stop this negative spiral and to act, identifying fragile patients in time, treating them promptly “, is the warning. Another element that emerged from the ‘Scope’ 21 Report is that osteoporotic fractures are associated with premature mortality.Approximately 30% of deaths after a hip or spine fracture can be attributed to the outcome of the event itself. More precisely, in the EU (plus the UK and Switzerland) around 250,000 deaths from fragility fractures were estimated in 2019. If 5% of people with a hip fracture die within 1 month and 25% within 12 months , early surgery (within 48 hours) is able to statistically and clinically reduce mortality at 1 year. In Italy, the average waiting times between hospitalization and surgery are around 2.5 days , superiors resp to Germany, Austria, the Netherlands, Sweden (12 hours), but less than Spain and Portugal (3 days). “Health policies play a significant role in promoting, funding and implementing care solutions, such as coordinated treatment models for patients who have suffered a fragility fracture – says Brandi – But if these can be considered a ‘universal’ solution to improve diagnosis, treatment and follow up of patients, more ‘local’ strategic solutions should also be considered, suitable to the specificity of the various regional health systems. “” One of the solutions to deal with this health emergency would be to recognize its priority, define its dimensions, simplify the criteria for access to pharmacological treatments and monitor outcomes “, concludes Brandi.