The Endocrine Society supports the U.S. National Bone Health Alliance (NBHA) response to the May 26 British Medical Journal paper, “Overdiagnosis of bone fragility in the quest to prevent hip fracture,” disputing the paper’s authors’ argument “that evidence for stratifying risk of fracture and subsequent drug therapy to prevent hip fracture is insufficient to warrant our current approach.”
The NBHA is a public-private partnership of 48 organizations, including the Endocrine Society, and five U.S. federal government agency liaisons, co-chaired by the American Society for Bone and Mineral Research (ASBMR) and the National Osteoporosis Foundation (NOF). The NBHA’s goal is to enact the recommendations outlined in the “2004 Bone Health and Osteoporosis: A Report of the United States Surgeon General” to reduce osteoporosis-related fractures.
The NBHA response disagrees with the paper’s authors — that treatment of osteoporosis is futile — and points out that this premise is contrary to the worldwide consensus that the fracture liaison service (FLS) model of care is the mechanism to get at the post-fracture diagnosis, screening, and treatment gap. The NBHA and its partners are focused on identifying those individuals at greatest risk for a second fracture: those who have already suffered from a previous osteoporotic fracture. Through the widespread implementation of FLS programs, the goal is to identify and treat osteoporosis in high-risk individuals. The response also identifies that treatment of individuals who have already experienced a fracture is effective and prevents secondary spine and hip fractures.
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