ECE2024 Poster Presentations Calcium and Bone (36 abstracts)
The association between the ‘time to first fracture’ and imminent fracture risk – data from the FRISBEE cohort
Jeroen M.K. de Filette 1 , Alexia Charles 2 , Amélie Bellanger 2 , Iconaru Laura 1 , Felicia Baleanu 1 , Murielle Surquin 3 , Bergmann Pierre 2,4 & Jean-Jacques Body 1,2,3
1CHU Brugmann, Endocrinology, Bruxelles, Belgium; 2CHU Brugmann, Laboratoire de Recherche Translationnelle, Bruxelles, Belgium; 3CHU Brugmann, Internal Medicine, Bruxelles, Belgium; 4CHU Brugmann, Nuclear Medicine, Bruxelles, Belgium
Background: Risk factors for fragility fractures were assessed in several prediction models (e.g. FRAX®, Garvan, FRISBEE, …). The predictors of a shorter ‘time to first fracture’ and its impact on imminent fracture risk, however, remain to be determined.
Methods: The concept of ‘time to first fracture’ between inclusion in the FRISBEE cohort (‘Fracture RIsk Brussels Epidemiological Enquiry’; 3560 postmenopausal women; median follow-up time of 10.1±2 years) and first fragility fracture was studied. Subjects with validated fractures were divided into 3 groups: first fracture < 2 years, 2-5 years, and >5 years after inclusion. Cox proportional hazard modeling using uni- and multivariate analysis was performed to evaluate factors associated with first fracture risk in these groups. Furthermore, the association between a short ‘time to first fracture’ as a risk factor for imminent fractures was analyzed. Differences between groups were evaluated by chi2-test.
Results: Classical risk factors (age, prior fracture, fall history and low BMD) were associated with first fracture in all groups. Previous glucocorticoid use and rheumatoid arthritis (RA) were predictors for early fracture (<2 years), consistent with the concept of very high risk. The ‘time to first fracture’ was not an independent risk factor for subsequent imminent fractures as FRAX® at baseline was significantly different between groups. Imminent fractures were similar in subjects with/without osteoporosis treatment (16.3 vs 15.5%) despite a higher estimated 10-year risk of fragility fracture in those treated, suggesting that treatment was efficient.
Conclusion: Among the risk factors considered, only previous glucocorticoid use and RA were specific predictors for early fracture. The ‘time to first fracture’ was not an independent risk factor for imminent fractures. Patients with a first osteoporotic fracture should thus be considered at very high risk for re-fracture, independent of the ‘time to first fracture’.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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