Title of project

Individualizing patient identification and treatment in osteoporosis – an epidemiological project

Abstract

Osteoporosis is a prevalent disease in Denmark, associated with high morbidity and mortality due to fractures from low-energy trauma. Dual X-ray Absorptiometry (DXA) is the standard diagnostic tool for osteoporosis, measuring bone mineral density (BMD). However, the relationship between BMD and fracture risk is influenced by factors such as body mass index (BMI), comorbidities, and medications. Utilizing a national DXA database containing data from 170,000 individuals, this project aims to investigate four key areas: the real-world effectiveness of oral bisphosphonates, BMD variations within the Danish population, the progression of BMD in the elderly, and the impact of antihypertensive treatments on BMD and fracture risk.

The first substudy focuses on identifying predictors of treatment failure in patients treated with bisphosphonates by analyzing BMD changes and fracture rates. The second substudy will evaluate factors contributing to BMD variations in Danish men and women over 50. The third substudy seeks to develop a predictive model to determine optimal intervals for repeat DXA scans in elderly patients, thereby reducing unnecessary testing. The final substudy will employ a target trial emulation method (an emulation of an RCT-study within a database) to assess the impact of antihypertensive treatments on fracture risk, controlling for confounders such as BMD, BMI, and comorbidities.

Supported by a multidisciplinary team, this research aims to personalize osteoporosis care, enhance treatment efficacy, and optimize resource use in clinical practice. The findings could significantly impact treatment guidelines, providing tailored therapeutic strategies that improve patient outcomes.