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Epidemiological Burden of Postmenopausal Osteoporosis in Italy from 2010 to 2020: Estimations from a Disease Model

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Abstract

The article describes the adaptation of a model to estimate the burden of postmenopausal osteoporosis in women aged 50 years and over in Italy between 2010 and 2020. For this purpose, a validated postmenopausal osteoporosis disease model developed for Sweden was adapted to Italy. For each year of the study, the ‘incident cohort’ (women experiencing a first osteoporotic fracture) was identified and run through a Markov model using 1-year cycles until 2020. Health states were based on the number of fractures and deaths. Fracture by site (hip, clinical vertebral, non-hip non-vertebral) was tracked for each health state. Transition probabilities reflected fracture site-specific risk of death and subsequent fractures. Model inputs specific to Italy included population size and life tables from 1970 to 2020, incidence of hip fracture and BMD by age in the general population (mean and standard deviation). The model estimated that the number of postmenopausal osteoporotic women would increase from 3.3 million to 3.7 million between 2010 and 2020 (+14.3 %). Assuming unchanged incidence rates by age group over time, the model predicted the overall number of osteoporotic fractures to increase from 285.0 to 335.8 thousand fractures between 2010 and 2020 (+17.8 %). The estimated expected increases in hip, vertebral and non-hip non-vertebral fractures were 22.3, 17.2 and 16.3 %, respectively. Due to demographic changes, the burden of fractures is expected to increase markedly by 2020.

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Acknowledgments

This study was supported by the International Osteoporosis Foundation and funded by Amgen (Europe) GmbH. The authors thank Dr. Matthew Gitlin of Amgen (Europe) GmbH for his involvement in this project, and Professor Alistair McGuire from the London School of Economics for his advice on the model development.

Conflict of Interest

Dr. PISCITELLI reports grants from AMGEN during the conduct of the study; grants from ABIOGEN, grants from SERVIER outside the submitted work. Dr. Brandi declares Research Grants obtained from Amgen, Eli Lilly, MSD, Novartis, Roche and Servier. The work undertaken by Hélène Cawston on the analysis and model development was done under contract to Amgen. A. Gauthier has nothing to disclose. Dr. Kanis reports personal fees from AgNovos healthcare USA, grants and personal fees from Amgen, personal fees from D3A, grants and personal fees from Lilly, personal fees from Medimaps, personal fees from Unigene, non-financial support from Asahi, grants from Medtronic, grants from Novartis, grants and personal fees from Pfizer, grants from Sanofi-Aventis, grants and personal fees from Servier, grants from Warner-Chilcott outside the submitted work. Dr. Compston reports grants from Amgen during the conduct of the study; personal fees from SERVIER, grants from WARNER-CHILCOTT, grants from ACUITAS, personal fees from NOVARTIS, personal fees from AMGEN, grants and personal fees from NYCOMED, personal fees from MEDTRONIC, personal fees from GILEAD, personal fees from GSK, personal fees from MSD outside the submitted work. Dr. Borgström reports grants from Amgen, grants from MSD, grants from Medtronic outside the submitted work. Dr. Cooper reports personal fees from consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Merck, Medtronic and Roche, outside the submitted work. Dr. McCloskey has nothing to disclose.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. I.O.S., Southern Italy Hospital Institute, Centro Direzionale, Isola E3, Palazzo Avalon, Naples, 80143, Italy

    P. Piscitelli

  2. Coleman Ltd, Centro Direzionale, Isola E3, Palazzo Avalon, Naples, 80143, Italy

    P. Piscitelli

  3. Department of Translational Medicine, University of Florence, Florence, Italy

    M. Brandi

  4. OptumInsight, Paris, France

    H. Cawston

  5. Amaris, London, UK

    A. Gauthier

  6. Department of Public Health, University of Glasgow, Glasgow, UK

    A. Gauthier

  7. Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK

    J. A. Kanis

  8. Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK

    J. Compston

  9. LIME/MMC, Karolinska Institutet, Stockholm, Sweden

    F. Borgström

  10. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    C. Cooper

  11. Norman Collisson Chair of Musculoskeletal Science, University of Oxford, Oxford, UK

    C. Cooper

  12. Academic Unit of Bone Metabolism, Metabolic Bone Centre, University of Sheffield, Sheffield, UK

    E. McCloskey

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  1. P. Piscitelli
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  2. M. Brandi
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  3. H. Cawston
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  4. A. Gauthier
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  5. J. A. Kanis
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  6. J. Compston
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  7. F. Borgström
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  8. C. Cooper
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  9. E. McCloskey
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Correspondence to P. Piscitelli.

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Piscitelli, P., Brandi, M., Cawston, H. et al. Epidemiological Burden of Postmenopausal Osteoporosis in Italy from 2010 to 2020: Estimations from a Disease Model. Calcif Tissue Int 95, 419–427 (2014). https://doi.org/10.1007/s00223-014-9910-3

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  • DOI: https://doi.org/10.1007/s00223-014-9910-3

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