Abstract
Summary
This article describes the development of a model for postmenopausal osteoporosis (PMO) based on Swedish data that is easily adaptable to other countries.
Introduction
The aims of the study were to develop and validate a model to describe the current/future burden of PMO in different national settings.
Methods
For validation purposes, the model was developed using Swedish data and provides estimates from 1990. 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 death. Fracture by site (hip, vertebral, and non-hip non-vertebral) was tracked for each health state. Transition probabilities reflected site-specific risk of death and subsequent fractures. Bone mineral density (BMD) was included as a model output; model inputs included population size and life tables from 1970 to 2020, incidence of fracture, relative risk of subsequent fractures based on prior fracture, relative risk of death following a fracture by site, and BMD by age (mean and standard deviation).
Results
Model predictions averaged across age groups estimated the incidence of hip, vertebral, and other osteoporotic fractures within a 5% margin of error versus published data. In Sweden, the number of osteoporotic fractures is expected to rise by 11.5% between 2009 and 2020, with a shift towards more vertebral fractures and multiple fractures.
Conclusion
The current PMO disease model is easily adaptable to other countries, providing a consistent measure of present and future burden of PMO in different settings.
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Acknowledgements
The study was supported by the International Osteoporosis Foundation and funded by Amgen (Europe) GmbH. The authors thank Dr. Matthew Gitlin and Sean Robbins from Amgen (Europe) GmbH for their involvement in this project, and Professor Alistair McGuire from the London School of Economics for his advice on the model development. Formatting/styling support was funded by Amgen (Europe) GmbH and GlaxoSmithKline.
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Gauthier, A., Kanis, J.A., Martin, M. et al. Development and validation of a disease model for postmenopausal osteoporosis. Osteoporos Int 22, 771–780 (2011). https://doi.org/10.1007/s00198-010-1358-3
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DOI: https://doi.org/10.1007/s00198-010-1358-3