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Spine Imaging Improves the Identification of Future Fracture Risk
in Postmenopausal Women With Osteoporosis
At any given bone mineral density, information regarding vertebral fractures
seen in spine imaging can predict up to 11-fold increased future fracture risk
WASHINGTON, April 7 /PRNewswire-FirstCall/ -- A new analysis gives clinicians
information to help them more accurately predict future osteoporotic fracture
risk in individual patients by combining information from both bone mineral
density (BMD) measurements and imaging of the spine.
The analysis, presented at the National Osteoporosis Foundation's Sixth
International Symposium on Osteoporosis, showed that at any given BMD, the
information from the imaging of the spine was an independent predictor for
future vertebral fractures.
"Low BMD is a surrogate for increased fracture risk, but doesn't give the whole
story. Imaging the spine allows practitioners to see whether fractures of the
spine have actually occurred," said Dr. John Krege, MD, Medical Advisor for Eli
Lilly and Company. "Incorporating both BMD and fracture status affords an
opportunity to better predict future fracture risk and appropriately treat
patients."
This data is important, because women identified as having increased risk for
fracture can be treated with lifestyle modifications, fall prevention
strategies, medications, and other measures to reduce their risk for future
fractures.
Methods
A post hoc analysis looking at data from 2,651 postmenopausal women (1,181 with
prevalent vertebral fracture) comprising the placebo groups from two large
osteoporosis trials with a median observation of 21 months and two years,
respectively, were analyzed to determine the impact of radiographic prevalent
vertebral fractures (fractures of the spine visible on radiographs at study
baseline) on future vertebral fracture risk independent of BMD. Prevalent
vertebral fracture status was defined as:
* The number of prevalent vertebral fractures 0, 1, 2, or greater than or
equal to 3
* Maximum semi-quantitative (SQ) deformity grade [Mild - grade 1; Moderate -
grade 2; severe - grade 3] (Genant et al. 1993)
* Spinal Deformity Index (SDI) score, an index of spine fracture burden
incorporating both number and severity of radiographic vertebral fractures.
Results
The analysis found that for any given BMD, the risk of a new vertebral fracture
was approximately increased three to 11-fold in subjects with one or more
prevalent radiographic vertebral fractures.
Greater numbers of prevalent vertebral fractures and more severe prevalent
vertebral fractures were associated with greater risks for subsequent fracture:
* 2 fractures = ~ 5-fold increase,
* greater than or equal to 3 fractures = 7 to 8-fold increase
Higher prevalent SQ scores were associated with greater risks
* SQ score of 2 = ~ 5-fold increase,
* SQ score of 3 = 8 to 10-fold increase
Similarly, higher prevalent SDI scores were associated with greater risks
* SDI score of 1 to 3 = ~ 3-fold increase,
* SDI score of 4 to 6 = 6 to 7-fold increase,
* SDI score of greater than or equal to 7 = 9 to 11-fold increase
About Osteoporosis
More than 50 percent of all women over the age of 75 are estimated to have
osteoporosis, and due to their advanced age, have a high risk of fracture. In
fact, most American women over the age of 50 will experience one or more
osteoporosis-related fractures during their lifetimes, and women with
osteoporosis who have two or more previous fractures have up to a nine times
greater risk of future fracture compared with women who have not suffered a
previous fracture.
About Lilly
Lilly, a leading innovation-driven corporation, is developing a growing
portfolio of first-in-class and best-in-class pharmaceutical products by
applying the latest research from its own worldwide laboratories and from
collaborations with eminent scientific organizations. Headquartered in
Indianapolis, Ind., Lilly provides answers -- through medicines and information
for some of the world's most urgent medical needs. Additional information
about Lilly is available at http://www.lilly.com/ .
(Logo: http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO )
http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO
DATASOURCE: Eli Lilly and Company
CONTACT: Keri S. McGrath of Eli Lilly and Company, +1-317-651-6001,
Email: