Women with sustained fracture history more likely to develop new ones

Women who have had osteoporotic fractures are more likely to sustain subsequent fractures, a recent study has found.

Researchers conducted a retrospective, observational cohort study on 231,769 women who had a history of at least one fragility fracture (group 1). Of these, 39,524 had had at least two fractures (group 2) and a further 7,656 had a history of three fractures (group 3). Participants were followed for up to 60 months or until the development of a major osteoporotic factor (MOF), the primary endpoint, or until death or end of data availability.

MOF occurred more frequently in women with histories of fracture. For instance, the 1-year cumulative incidence rate in group 1 was 5.1 percent, as compared to only 2.5 percent in matched controls. Corresponding values for group 2 and 3 were 8.6 percent (vs 3.3 percent) and 5.4 percent (vs 3.5 percent).

This trend persisted over time. At 5 years, the cumulative incidence rates of any MOF in groups 1 and 2 were 20.7 percent and 32.0 percent, respectively, which were greater than those in matched controls (32.0 percent vs 15.3 percent, respectively). Limited follow-up precluded this analysis in group 3.

This was confirmed in subsequent risk analysis, which found that the risk of any MOF was significantly elevated in group 1 and 2 participants up to 49–60 months after the index fracture. Disaggregating according to age did not attenuate this relationship, and neither did stratifying patients according to the type of their initial fracture.

For group 3 participants aged <80 years, fracture history generally elevated the risk of subsequent MOFs for the first 24 months after the index event. For those older than 80 years, the risk was reduced at 7–12 months and beyond.