OBJECTIVES : In Germany, over 7 million adults ≥50 years of age have osteoporosis. New risk factors for fractures were recently added to the Dachverband Osteologie guidelines.¹ Recent data regarding the distribution of these risk factors in the German population is lacking. This study estimated the prevalence of these risk factors and the osteoporosis epidemiology and treatment gap in the general population ≥50 years old in Germany.

METHODS : Our retrospective cohort study included persons ≥50 years of age registered in an anonymized German claims database (InGef research database) between January 2013 and December 2018. The database sample consisted of approximately 4 million insured persons representative of the age and sex demographic of the total German population. The primary outcomes, stratified by year, sex, and age, were osteoporotic fracture risk factors and osteoporosis prevalence. Osteoporosis was identified by either the presence of osteoporosis-specific drugs, osteoporotic fractures, and/or diagnosis of osteoporosis. We report results for 2018.

RESULTS : In 2018, 1,559,299 persons ≥50 years of age were enrolled in the InGef research database. Prevalence of risk factors of interest included: glucocorticoids (9.6% of persons); underweight (2.4%); aromatase inhibitor (0.6%); hormone ablative therapy in men (0.6%); and major osteoporotic fractures (0.5%). Overall, osteoporosis prevalence was 15.9% (248,206/1,559,299; 87.5% female). Among persons with an osteoporotic fracture, only 39.0% (4,179/10,709) had an osteoporosis diagnosis. Among persons with an osteoporosis diagnosis, an osteoporotic fracture, or an osteoporosis diagnosis and/or osteoporotic fracture, 31.0% (48,327/155,930), 21.7% (2,323/10,709), and 30.0% (48,766/162,740) received an osteoporosis-specific prescription, respectively.

CONCLUSIONS : Although osteoporosis is common in the German population ≥50 years of age, many persons do not receive a formal diagnosis and are not treated for their disease, even after an osteoporotic fracture.

REFERENCE:

1. Dachverband Osteologie e.V. DVO-Leitlinie: Prophylaxe, Diagnostik und Therapie der OSTEOPOROSE bei postmenopausalen Frauen und bei Männern. 2017.