Risk of new vertebral fracture in the year following a fracture

wbldb

Lindsay, Robert¹; Silverman, Stuart L.²; Cooper, Cyrus³; Hanley, David A.⁴; Barton, Ian⁵; Broy, Susan B.⁶; Licata, Angelo⁷; Benhamou, Laurent⁸; Geusens, Piet^9,10; Flowers, Kirsten¹¹; Stracke, Hilmar¹²; Seeman, Ego¹³

Risk of new vertebral fracture in the year following a fracture

JAMA. January 17, 2001;285(6):320-323

©2001 American Medical Association. All rights reserved.

Affiliations

¹Regional Bone Center, Helen Hayes Hospital, West Haverstraw, NY

²Osteoporosis Medical Center, Cedars Sinai Medical Center, and Greater Los Angeles VA Health System, Los Angeles, Calif

³Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southampton, England

⁴University of Calgary Health Sciences Centre, Calgary, Alberta

⁵Procter & Gamble Pharmaceuticals, Staines, Middlesex, England

⁶Center for Arthritis and Osteoporosis, Illinois Bone and Joint Institute, Des Plaines

⁷Cleveland Clinic Foundation, Cleveland, Ohio

⁸Centre Hospitalier d’Orleans, Orleans, France

⁹Limburg University Center, Diepenbeek, Belgium

¹⁰University of Maastricht, the Netherlands

¹¹Procter & Gamble Pharmaceuticals, Cincinnati, Ohio

¹²Justus-Liebig University, Giessen, Germany

¹³University of Melbourne, Melbourne, Australia
Abstract

Context: Vertebral fractures significantly increase lifetime risk of future fractures, but risk of further vertebral fractures in the period immediately following a vertebral fracture has not been evaluated.

Objective: To determine the incidence of further vertebral fracture in the year following a vertebral fracture.

Design and Setting: Analysis of data from 4 large 3-year osteoporosis treatment trials conducted at 373 study centers in North America, Europe, Australia, and New Zealand from November 1993 to April 1998.

Subjects: Postmenopausal women who had been randomized to a placebo group and for whom vertebral fracture status was known at entry (n = 2725).

Main Outcome Measure: Occurrence of radiographically identified vertebral fracture during the year following an incident vertebral fracture.

Results: Subjects were a mean age of 74 years and had a mean of 28 years since menopause. The cumulative incidence of new vertebral fractures in the first year was 6.6%. Presence of 1 or more vertebral fractures at baseline increased risk of sustaining a vertebral fracture by 5-fold during the initial year of the study compared with the incidence in subjects without prevalent vertebral fractures at baseline (relative risk [RR], 5.1; 95% confidence interval [CI], 3.1-8.4; P<.001). Among the 381 participants who developed an incident vertebral fracture, the incidence of a new vertebral fracture in the subsequent year was 19.2% (95% CI, 13.6%-24.8%). This risk was also increased in the presence of prevalent vertebral fractures (RR, 9.3; 95% CI, 1.2-71.6; P = .03).

Conclusion: Our data indicate that women who develop a vertebral fracture are at substantial risk for additional fracture within the next year.
Links

DOI: 10.1001/jama.285.3.320

PubMed: 11176842

WoS: 000166324300023

Cited Works (9)

Year	Entry
1993	Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD. Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporos Int. May 1993;3(3):120-126.
1991	Ross PD, Davis JW, Epstein RS, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. June 1, 1991;114(11):919-923.
1992	Cooper C, Atkinson EJ, O'Fallon WM, Melton JL III. Incidence of clinically diagnosed vertebral fractures: a population‐based study in Rochester, Minnesota, 1985‐1989. J Bone Miner Res. February 1992;7(2):221-227.
2000	Reginster J-Y, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R; Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Osteoporos Int. January 2000;11(1):83-91.
1999	Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH III, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD; Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. JAMA. October 13, 1999;282(14):1344-1352.
2000	Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA III, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. April 2000;15(4):721-739.
1999	Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR; Study of Osteoporotic Fractures Research Group. Vertebral fractures and mortality in older women: a prospective study. Arch Intern Med. June 14, 1999;159(11):1215-1220.
1999	Black DM, Arden NK, Palermo L, Pearson J, Cummings SR; Study of Osteoporotic Fractures Research Group. Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. J Bone Miner Res. May 1999;14(5):821-828.
1999	Melton LJ III, Atkinson EJ, Cooper C, O’Fallon WM, Riggs BL. Vertebral fractures predict subsequent fractures. Osteoporos Int. September 1999;10(3):214-221.

Cited By (63)

Year	Entry
2009	van Geel TACM, van Helden S, Geusens PP, Winkens B, Dinant G-J. Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. January 2009;68(1):99-102.
2017	Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, Hope S, Kanis JA, McCloskey EV, Poole KES, Reid DM, Selby P, Thompson F, Thurston A, Vine N; The National Osteoporosis Guideline Group (NOGG). UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. December 2017;12(1):1-24.
2003	Delmas PD, Genant HK, Crans GG, Stock JL, Wong M, Siris E, Adachi JD. Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone. October 2003;33(4):522-532.
2004	Kanis J, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey E, Mellstrom D, Melton L, Pols H, Reeve J, Silman A, Tenenhouse A. A meta-analysis of previous fracture and subsequent fracture risk. Bone. August 2004;35(2):375-382.
2006	Reginster J-Y, Burlet N. Osteoporosis: a still increasing prevalence. Bone. February 2006;38(2)(suppl 1):4-9.
2020	Yokomoto-Umakoshi M, Umakoshi H, Fukumoto T, Matsuda Y, Nagata H, Ogata M, Kawate H, Miyazawa T, Sakamoto R, Ogawa Y; Q-AND-A study group. Pheochromocytoma and paraganglioma: an emerging cause of secondary osteoporosis. Bone. April 2020;133:115221.
2020	Yang J, Mao Y, Nieves JW. Identification of prevalent vertebral fractures using vertebral fracture assessment (VFA) in asymptomatic postmenopausal women: a systematic review and meta-analysis. Bone. July 2020;136:115358.
2020	Majjad A, Ghassem MA, Toufik H, Sadni S, Debbarh Z, Djossou JH, El Ouardi N, Taoubane L, Abouqal R, Achemlal L, El Maghraoui A. Relationship between vertebral fracture prevalence and abdominal aortic calcification in women with rheumatoid arthritis. Bone. December 2020;141:115599.
2022	Geusens P, Feldman R, Oates M, Thomas T, Makras P, Jakob F, Langdahl B, Wang Z, Rojeski M, Libanati C. Romosozumab reduces incidence of new vertebral fractures across severity grades among postmenopausal women with osteoporosis. Bone. January 2022;154:116209.
2022	Monchka BA, Schousboe JT, Davidson MJ, Kimelman D, Hans D, Raina P, Leslie WD. Development of a manufacturer-independent convolutional neural network for the automated identification of vertebral compression fractures in vertebral fracture assessment images using active learning. Bone. August 1, 2022;161:116427.
2020	Geusens P, Kendler DL, Fahrleitner-Pammer A, López-Romero P, Marin F. Distribution of prevalent and incident vertebral fractures and their association with bone mineral density in postmenopausal women in the teriparatide versus risedronate vero clinical trial. Calcif Tiss Int. June 2020;106(6):646-654.
2002	Brown JP, Josse RG; Scientific Advisory Council of the Osteoporosis Society of Canada. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can Med Assoc J. November 12, 2002;167(suppl 10):S1-S34.
2010	Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD; Scientific Advisory Council of Osteoporosis Canada. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. Can Med Assoc J. November 23, 2010;182(17):1864-1873.
2016	Camacho PM, Petak SM, Binkley N, Clarke BL, Harris ST, Hurley DL, Kleerekoper M, Lewiecki EM, Miller PD, Narula HS, Pessah-Pollack R, Tangpricha V, Wimalawansa SJ, Watts NB. American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis — 2016. Endocr Pract. September 1, 2016;22(suppl 4):1-42.
2020	Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A, Harris ST, Hurley DL, Kelly J, Lewiecki EM, Pessah-Pollack R, McClung M, Wimalawansa SJ, Watts NB. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis: 2020 update. Endocr Pract. May 2020;26(suppl 1):1-46.
2002	Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C; The Osteoporosis Methodology Group; The Osteoporosis Research Advisory Group. Meta-analyses of therapies for postmenopausal osteoporosis, IX: summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev. August 2002;23(4):570-578.
2016	Miller PD, Hattersley G, Riis BJ, Williams GC, Lau E, Russo LA, Alexandersen P, Zerbini CAF, Hu M-y, Harris AG, Fitzpatrick LA, Cosman F, Christiansen C; ACTIVE Study Investigators. Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial. JAMA. August 16, 2016;316(7):722-733.
2002	Sarkar S, Mitlak BH, Wong M, Stock JL, Black DM, Harper KD. Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy. J Bone Miner Res. January 2002;17(1):1-10.
2002	Borah B, Dufresne TE, Chmielewski PA, Gross GJ, Prenger MC, Phipps RJ. Risedronate preserves trabecular architecture and increases bone strength in vertebra of ovariectomized minipigs as measured by three‐dimensional microcomputed tomography. J Bone Miner Res. July 2002;17(7):1139-1147.
2005	Delmas PD, van de Langerijt L, Watts NB, Eastell R, Genant H, Grauer A, Cahall DL; IMPACT Study Group. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res. April 2005;20(4):557-563.
2005	Sornay-Rendu E, Munoz F, Garnero P, Duboeuf F, Delmas PD. Identification of osteopenic women at high risk of fracture: the OFELY study. J Bone Miner Res. October 2005;20(10):1813-1819.
2009	Sornay-Rendu E, Cabrera-Bravo J-L, Boutroy S, Munoz F, Delmas PD. Severity of vertebral fractures is associated with alterations of cortical architecture in postmenopausal women. J Bone Miner Res. April 2009;24(4):737-743.
2012	Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley JA, Cosman F, Cummings SR, Hue TF, Lippuner K, Lakatos P, Leung PC, Man Z, Martinez RLM, Tan M, Ruzycky ME, Su G, Eastell R. The effect of 3 versus 6 years of Zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. February 2012;27(2):243-254.
2014	Kanis JA, Svedbom A, Harvey N, McCloskey EV. The osteoporosis treatment gap. J Bone Miner Res. September 2014;29(9):1926-1928.
2016	Adler RA, Fuleihan GE-H, Bauer DC, Camacho PM, Clarke BL, Clines GA, Compston JE, Drake MT, Edwards BJ, Favus MJ, Greenspan SL, McKinney R Jr, Pignolo RJ, Sellmeyer DE. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2016;31(1):16-35.
2019	Emami AJ, Toupadakis CA, Telek SM, Fyhrie DP, Yellowley CE, Christiansen BA. Age dependence of systemic bone loss and recovery following femur fracture in mice. J Bone Miner Res. January 2019;34(1):157-170.
2020	Fung E. Early alendronate can be safe during fracture healing? J Bone Miner Res. January 2020;35(1):214-214.
2020	Cosman F, McMahon D, Dempster D, Nieves JW. Standard versus cyclic teriparatide and denosumab treatment for osteoporosis: a randomized trial. J Bone Miner Res. February 2020;35(2):219-225.
2020	Toth E, Banefelt J, Åkesson K, Spångeus A, Ortsäter G, Libanati C. History of previous fracture and imminent fracture risk in Swedish women aged 55 to 90 years presenting with a fragility fracture. J Bone Miner Res. May 2020;35(5):861-868.
2022	Leslie WD, Morin SN, Lix LM, McCloskey EV, Johansson H, Harvey NC, Kanis JA. The effect of fracture recency on observed 10-year fracture probability: a registry-based cohort study. J Bone Miner Res. May 2022;37(5):848-855.
2019	Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. May 2019;104(5):1595-1622.
2009	KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD–MBD). Kidney Int. August 2009;76(suppl 113):S1-S130.
2002	Delmas PD. Treatment of postmenopausal osteoporosis. Lancet. June 8, 2002;359(9322):2018-2026.
2004	Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jönsson B. Fracture risk following an osteoporotic fracture. Osteoporos Int. March 2004;15(3):175-179.
2005	Kanis JA, Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int. March 2005;16(3):229-238.
2017	Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E, Sigurdsson G, Kanis JA. Imminent risk of fracture after fracture. Osteoporos Int. March 2017;28(3):775-780.
2017	Roux C, Briot K. Imminent fracture risk. Osteoporos Int. June 2017;28(6):1765-1769.
2020	Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, Cooper C, Rizzoli R, Adib G, Al-Daghri N, Campusano C, Chandran M, Dawson-Hughes B, Javaid K, Jiwa F, Johansson H, Lee JK, Liu E, Messina D, Mkinsi O, Pinto D, Prieto-Alhambra D, Saag K, Xia W, Zakraoui L, Reginster J-Y. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int. January 2020;31(1):1-12.
2020	Paggiosi MA, Debono M, Walsh JS, Peel NFA, Eastell R. Quantitative computed tomography discriminates between postmenopausal women with low spine bone mineral density with vertebral fractures and those with low spine bone mineral density only: the SHATTER study. Osteoporos Int. April 2020;31(4):667-675.
2020	Kanis JA, Johansson H, Harvey NC, Gudnason V, Sigurdsson G, Siggeirsdottir K, Lorentzon M, Liu E, Vandenput L, McCloskey EV. Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures. Osteoporos Int. October 2020;31(10):1817-1828.
2020	Turcotte A-F, Kukuljan S, Dalla Via J, Gagnon C, Abbott G, Daly RM. Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-component exercise program in older men: secondary analysis of an 18-month randomized controlled trial. Osteoporos Int. October 2020;31(10):2025-2035.
2020	Yang J, Cosman F, Stone PW, Li M, Nieves JW. Vertebral fracture assessment (VFA) for osteoporosis screening in US postmenopausal women: is it cost-effective? Osteoporos Int. December 2020;31(12):2321-2335.
2021	Kanis JA, Johansson H, Harvey NC, Gudnason V, Sigurdsson G, Siggeirsdottir K, Lorentzon M, Liu E, Vandenput L, Leslie WD, McCloskey EV. The use of 2-, 5-, and 10-year probabilities to characterize fracture risk after a recent sentinel fracture. Osteoporos Int. January 2021;32(1):47-54.
2021	Messina C, Rinaudo L, Cesana BM, Maresca D, Piodi LP, Sconfienza LM, Sardanelli F, Ulivieri FM. Prediction of osteoporotic fragility re-fracture with lumbar spine DXA-based derived bone strain index: a multicenter validation study. Osteoporos Int. January 2021;32(1):85-91.
2021	Lems WF, Paccou J, Zhang J, Fuggle NR, Chandran M, Harvey NC, Cooper C, Javaid K, Ferrari S, Akesson KE; International Osteoporosis Foundation Fracture Working Group. Vertebral fracture: epidemiology, impact and use of DXA vertebral fracture assessment in fracture liaison services. Osteoporos Int. March 2021;32(3):399-411.
2021	Ong T, Copeland R, Thiam CN, Cerda Mas G, Marshall L, Sahota O. Integration of a vertebral fracture identification service into a fracture liaison service: a quality improvement project. Osteoporos Int. May 2021;32(5):921-926.
2013	Hussein Ali AI. 3-D Visualization and Prediction of Spine Fractures Under Axial Loading [PhD thesis]. Boston University; 2013.
2015	Jackman TM. Prediction of Vertebral Fractures Under Axial Compression and Anterior Flexion [PhD thesis]. Boston University; 2015.
2016	Fein P. Associations Between the Spatial Distribution of Bone Density in the Vertebra and Intervertebral Disc Health [Master's thesis]. Boston University; 2016.
2012	Moayyeri A. Risk Assessment for Osteoporotic Fractures Among Men and Women from a Prospective Population Study: The EPIC-Norfolk Study [PhD thesis]. Cambridge, UK: University of Cambridge; 2012.
2019	Schwemmer AC. Die Beurteilung der Knochendichte und Knochenqualität von Wirbelkörpern bei Osteoporose: ein Vergleich radiologischer Methoden in vivo mit dem MicroCT [PhD thesis]. Berlin, Germany: Charité – Universitätsmedizin Berlin; December 13, 2019.
2016	Wang J. Plate-Rod Microstructural Modeling for Accurate and Fast Assessment of Bone Strength [PhD thesis]. Columbia University; 2016.
2015	Brock GR Jr. Changes in Bone Tissue Properties With Osteoporosis Treatment [PhD thesis]. Ithaca, NY: Cornell University; January 2015.
2018	Chen JTH. Alterations in Bone Tissue Properties With Parathyroid Hormone Treatment [PhD thesis]. Ithaca, NY: Cornell University; May 2018.
2016	Oei L. Epidemiological, Radiological and Genetic Aspects of Endocrine Bone Diseases [PhD thesis]. Erasmus University Rotterdam; December 14, 2016.
2008	Xu Q. Evaluation of Bone Quality Using Novel Image Analyses and Mechanical Testing Methods [PhD thesis]. Louisville, KY: University of Louisville; August 2008.
2015	Bruno AG. Investigation of Spine Loading to Understand Vertebral Fractures [PhD thesis]. Cambridge, MA: Massachusetts Institute of Technology; June 2015.
2014	Kaipatur NR. Impact of Bisphosphonate Bone Burden on Orthodontic Tooth Movement [PhD thesis]. Edmonton, AB: University of Alberta; 2014.
2005	Sran MM. Manual Therapy and the Osteoporotic Spine [PhD thesis]. Vancouver, BC: University of British Columbia; March 2005.
2018	George JK. Using Finite Element Models Under Multiple Loading Conditions to Improve the Association Between Radius and Tibia Microarchitecture and Prevalent Osteoporotic Vertebral Fracture [Master's thesis]. Calgary, AB: University of Calgary; May 2018.
2019	Emami AJ. Systemic Bone Loss After Femoral Fracture in Mice: Potential Mechanisms and Age-Related Effects [PhD thesis]. Davis, University of California; 2019.
2016	Ziebart C. The Association Between Fractures, Posture and Physical Performance Measures in Women Over the Age of 65 [Master's thesis]. University of Waterloo; 2016.
2022	Ponzano M. Risk Assessment and Interventions for Individuals At Risk of Osteoporotic Fractures [PhD thesis]. University of Waterloo; 2022.