Incidence of osteoporotic hip fractures expected to escalate in some Eurasian countries

A detailed analysis of the burden of osteoporosis in eight Eurasian countries has found that osteoporosis is a significant and growing health problem in the region that will escalate in the future due to expected demographic changes.

The authors of the Audit report carried out a review of the available literature and a survey of the representatives of the national osteoporosis societies in eight Eurasian countries. The Audit reviews both the burden and the differences between Armenia, Belarus, Georgia, Moldova, Kazakhstan, the Kyrgyz Republic, the Russian Federation, and Uzbekistan with regard to the prevalence of osteoporosis and incidence of osteoporotic fractures, future demographic changes, diagnostic resources, and treatment availability.

The findings reveal:

• The expected number of osteoporosis patients varies from 240,000 in Armenia to 16 million in the Russian Federation.
• Fragility fractures represent a serious health problem in all countries, with the highest incidence in Kazakhstan and the Russia Federation.
• In all the countries audited, according to a systematic review of hip fracture incidence worldwide, women are at moderate risk (200-300/100,000 persons per year) of hip fracture while men are at moderate (100-150/100,000) to high (150/100,000) risk in the Russian Federation, Uzbekistan and Kazakhstan.
• The rate of hospitalization following hip fracture in the majority of countries is low (33-80%), considerably below international standards.
• In the coming decades the populations, in particular of Uzbekistan, Kazakhstan, and Kyrgyzstan, will continue to see increases in life expectancy with a corresponding increase in the number of fractures in older people. Thus, in 2050, the number of hip fractures in these countries is expected to increase by 2.5-3.5 times.
• The availability of DXA devices in the region is low (0.2-1.3 per million), and DXA scans are expensive.
• Almost all current treatments are available, but in countries which do not provide coverage, the costs of even the most commonly prescribed bisphosphonate is prohibitively high for the majority of people with osteoporosis.

Professor Olga Lesnyak, lead author of the Audit, stated:

"We were pleased to see that in the 10 years since the previous International Osteoporosis Foundation (IOF) Audit2, some progress has been made in the region. However, the Audit clearly shows that there are enormous gaps and a great need for improvement in the fight against osteoporosis and related fractures, particularly in the face of expected demographic changes. We have identified an unacceptable absence of organized, specialized trauma care for hip fracture patients and continued poor accessibility to diagnosis, preventive treatments and post-fracture care in most countries of region."

With the expected demographic changes in the Eurasian region there will be a significant increase in the number of people with osteoporosis. To stem the tide of disability and loss of independence due to fragility fractures, urgent action is needed now at the national level in each country. This must begin with the recognition of osteoporosis as a priority health issue. We very much hope that this Audit will provide valuable insights and recommendations for health policy advances that will lead to fewer fractures and better patient outcomes in the region."

Dr Philippe Halbout, IOF CEO

The authors and the national osteoporosis societies which contributed to the regional Audit have been commended by Professor Jean-Yves Reginster, Chair of the IOF Committee of National Societies (CNS):

"IOF is honoured to count 14 societies from the Eurasian region in its network of 260 member organizations from across the world. We congratulate the member societies and lead authors on this important initiative which highlights the burden of osteoporosis and identifies the key areas that must be addressed now and in the future."