The Efficacy of Pharmacotherapy in Postmenopausal Osteoporosis: a Longitudinal Observational Study

Introduction: The aim of the study was an assessment of longitudinal changes in fracture probability in postmenopausal women. Material and methods: A group of 226 postmenopausal women at baseline mean age 66.46 +/- 7.96 years were studied. There were 21 women without therapy, 102 taking calcium + vitamin D, and 103 women on antiresorptive therapy, in the study group. Data concerning clinical risk factors for osteoporosis and hip BMD were gathered. Fracture probability for major and hip fractures was established using FRAX (TM). Results: Mean follow-up time was 2.43 +/- 0.59 years. Baseline FRAX value in the whole group for major fracture was 7.1 +/- 4.18, and at follow-up it was 7.44 +/- 4.04. Respective results for FRAX for hip fracture were 3.17 +/- 2.69 and 3.02 +/- 2.35. In the whole group the probability for major fractures significantly increased during follow-up (p < 0.05) and for hip fracture did not change. In non-treated patients and patients taking calcium + vitamin D the fracture probability increased significantly. In patients on antiresorptive therapy the fracture probability did not change, which was connected with an improvement in bone status assessed by DXA. Femoral neck T-score in the whole group did not change, in those not treated and taking calcium + vitamin D it decreased significantly (p < 0.05), while in treated women it increased significantly (p < 0.05). In patients with improved bone status the FRAX values for major and hip fractures decreased by 0.44 +/- 1.62 and 0.36 +/- 1.19, respectively. Conversely, in patients with worsening T-score value the FRAX values increased by 1.33 +/- 1.42 and 0.66 +/- 1.25, respectively. Conclusion: Antiresorptive therapy stabilises fracture probability in postmenopausal women due to improvement in bone status.