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Joint Bone Spine
Volume 77, n° S2
pages 128-132 (décembre 2010)
Doi : 10.1016/S1297-319X(10)70008-7
Defining treatment failure in severe osteoporosis
 

Cyrille B. Confavreux a, , Julien Paccou b, Claire David c, Nadia Mehsen d, Ariane Leboime e, Thierry Thomas f
a INSERM U831 et Université de Lyon, Service de Rhumatologie, Hospices Civils de Lyon, Lyon, France 
b Département Universitaire de Rhumatologie, CHU, Hôpital Roger Salengro, Lille, France 
c Service de Rhumatologie, CHU Hôpital Sud, 16, boulevard de Bulgarie, Rennes, France 
d CHU Pellegrin, Service de Rhumatologie, 1, place Amélie Raba Léon, Bordeaux, France 
e Université Paris-Descartes, Hôpital Cochin, Service de Rhumatologie B, 27, rue du faubourg Saint-Jacques, Paris, France 
f INSERM U890 et Service de Rhumatologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France 

Corresponding author.
Summary

The management of postmenopausal osteoporosis has benefited from the recent introduction of several new drug classes and is now well standardized. However, none of the available osteoporosis drugs completely abolishes the occurrence of fractures. Therefore, criteria are needed to determine when the occurrence of a fracture during treatment indicates failure to respond to the drug. Such criteria would improve patient management. A panel of national osteoporosis experts was convened to discuss data from a literature review on severe osteoporosis (Osteoporosis DIagnosis and Surveillance of SEvErity, ODISSEE). The experts reached a consensus that “an inadequate response to treatment for postmenopausal osteoporosis is the occurrence, in a patient with severe osteoporosis, adequate calcium and vitamin D intakes, and good treatment adherence, of any of the following: incident major fracture within the first treatment year, more than one minor insufficiency fracture, or a bone mineral density decrease by at least the smallest significant amount (0.03 g/cm2) after 5 years or earlier in the event of a minor fracture”.

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Keywords : Osteoporosis, Treatment, Adherence, Treatment failure, Inadequate response




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