Jeffrey Curtis, MD: Addressing Osteoporosis in in Men


Jeffrey Curtis, MD, MS, MPH, offers his thoughts on the most effective methods to address the underdiagnosis and undertreatment of osteoporosis in older male patients.

Often times in medicine, a topic or cause becomes so large it can cast a proverbial shadow on other aspects of care. In rheumatology, this has caused gender disparities in the diagnosis and treatment of osteoporosis.

While bone health in women is a well-known issue, the lack of public interest and emphasis has caused the management of osteoporosis in men has caused it to under the radar for many patients and clinicians. In a recent study presented at ACR Convergence, investigators from the University of Alabama at Birmingham sought to quantify the apparent undertreatment and underdiagnosis of osteoporosis in older men.

Using Medicare fee-for-service beneficiaries, investigators identified a cohort of more than 9000 patients aged 65 or older with a closed-fragility or osteoporosis-related fracture during a 4-year period. Upon analysis, investigators found 62.8% of patients had a history of musculoskeletal pain and 48.5% had a history of opioid use 1 year prior to their index fracture, but only 6% had a bone mineral density test in the past 2 years.

Overall, 92.8% did not have a claim for diagnosis or treatment of osteoporosis at baseline. Investigators also noted a trend in declining DXA scans from 2012-2014 (65-69 years, 6.3 to 5.5%; 70-74 years, 4.7 to 4.0%) with this trend being even more pronounced in those 75 or older (6.0 to 4.3%).

To learn more about the topic, we reached out to lead investigator Jeffrey Curtis, MD, MS, MPH.

This study, “Characterization of Older Male Patients with a Fragility Fracture,” was presented at ACR Convergence.

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