BONE DENSITY AND OSTEOPOROSIS

Bone density measurement and treatments of osteoporosis

Background

The objective of this review was to provide a summary of the available scientific evidence regarding the performance of bone density measurement (BDM) techniques and the effectiveness of BDM screening and related interventions (hormone replacement therapy (HRT) and intranasal salmon calcitonin SCT(N)) in menopausal women to prevent fractures in later life.

Findings

The currently available evidence does not support the use of BDM screening in combination with HRT or SCT(N) treatment.

The analytical performance of BDM technologies in the routine clinical situation has not been adequately assessed. Fair evidence from prospective cohort studies suggests that BDM can predict the risk of fractures, but not with high accuracy. Although good evidence exists to support the efficacy of HRT and SCT(N) in preserving bone mass during treatment, there is also fair evidence that the effect wears off after cessation of therapy. Fair evidence, from low quality RCTs and observational studies, suggests that these therapies are efficacious in preventing fractures. However, when this evidence is used to evaluate the potential effectiveness of BDM screening of menopausal women in combination with these therapies, it is estimated, using optimistic assumptions, that only 1-7% of hip fractures might be prevented.

Conducted by: CRD in collaboration with INAHTA member organisations

Publications

Hailey D, Sampietro-Colom L, Marshall D, Rico R, Granados A, Asua J, Sheldon T. Bone density measurement and treatments of osteoporosis: statement of findings. Edmonton, Alberta: Alberta Heritage Foundation for Medical Research; 1996

Funding

Commissioned by INAHTA