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Joint Bone Spine
Volume 77, n° S2
pages 133-138 (décembre 2010)
Doi : 10.1016/S1297-319X(10)70009-9
Management of patients with incident fractures during osteoporosis treatment

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

Corresponding author.

Official recommendations are available for detecting osteoporosis and initiating osteoporosis medications in postmenopausal women. However, there are no recommendations about the management of patients with incident fractures despite osteoporosis therapy. Second-line osteoporosis treatments have been evaluated only based on laboratory and absorptiometry criteria. Nevertheless, we will try to answer the following questions: (1) What criteria should be used to determine whether a fracture during osteoporosis treatment indicates treatment failure (low-energy fracture, fracture not due to an intercurrent health condition, fracture of the type targeted by the osteoporosis treatment, sufficient treatment duration at occurrence of the fracture, and good adherence to the treatment and to vitamin D supplementation)? (2) In patients with treatment failure or an inadequate clinical response, defined as a fracture despite adherence to osteoporosis therapy for at least 1 year, what are the best treatment strategies?

The full text of this article is available in PDF format.

Keywords : Treatment failure, Osteoporotic fracture, Treatment alternatives, Osteoporosis medications

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