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AB1371 Severity of incident vertebral fracture and future fracture risk: A 3-year prospective study
  1. O. Bruyere1,
  2. C. Roux2,
  3. D. Nicolet1,
  4. J. Fechtenbaum2,
  5. R. Deroisy1,
  6. J.-Y. Reginster1
  1. 1Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
  2. 2Rheumatology, Cochin Hospital, Paris, France

Abstract

Objectives To examine whether the severity of an incident vertebral fracture can predict subsequent fracture.

Methods Analysis from the placebo group of two 3-year randomized controlled trials investigating the clinical effect of an anti-osteoporotic drug. Vertebral and major non-vertebral fractures (i.e. ribs sternum, wrist region, pelvic sacrum, collarbone, humerus, proximal femur) were assessed during 3 years. At the end of the first year, each vertebra received a severity grade corresponding to either no fracture either a mild, moderate or severe fracture based on a semi-quantitative visual assessment on standard radiographs. All women received calcium and vitamin D during the 3 years of the study.

Results 2550 women aged mean (SD) 74.4 (6.1) years were included in the present analysis. After one year of follow-up, 6.9% of the women (n=271) experienced a new vertebral fracture. Among these new fractures, 47.8% were mild, 30.9% were moderate and 21% were severe. During the following two years of follow-up (i.e. years 2 and 3), 410 patients experienced a new vertebral fracture. Among women with an incident vertebral fracture at year 1, 28.0% experienced a new vertebral fracture during years 2 and 3. However, this rate of new fracture was only 15.4% among women without incident vertebral fracture during the first year of follow-up. Compared to women without new vertebral fracture after one year of follow-up, women who experienced a severe fracture during year 1 have an increased risk of new vertebral fractures during the following two years (OR 2.39 [1.56-3.67]). When considering major non-vertebral fracture, 149 subjects experienced such fractures during year 2 and 3. Women who experienced a severe vertebral fracture during the first year have an increased risk of major non-vertebral fractures during the following two years compared to women without incident vertebral fracture after one year of follow-up (OR 2.31 [1.01-5.32]).

Conclusions New severe incident vertebral fracture is an independent predictor of new vertebral and non-vertebral fractures that could be taken into account in fracture risk management.

Disclosure of Interest None Declared

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