How Is Osteoporosis Impacting The Quality Of Life?

Osteoporosis is a significant health burden worldwide and associated with pain and decreased physical, social, and mental well-being. The affected person experiences prolonged immobilisation and limited daily activities, which deteriorates the quality of life. At the economic level, fractures due to osteoporosis require various healthcare resources and expenditure on treatment, hospitalisation and postoperative complications. Besides all these, it also demands long-term care for fracture treatment and follow-ups. Osteoporosis is related to the high morbidity and mortality of hip fractures. The incidence of hip fractures increases exponentially with age but in recent times the significant burden of vertebral fractures is also observed. Similarly, the chance for future fractures is also there, along with other associated complications such as depression, functional impairment, pain, and disability. 

Osteoporosis is a condition that leads to weak bones due to a change in bone structure and bone density. In Osteoporosis, porousness is developed in the bones, making them more prone to break or fracture easily. Various factors lead to Osteoporosis, and it causes significant health problems. Older women are found to be more affected by it as compared to other groups. 

What common is Osteoporosis?

Osteoporosis specifically affects older people and women. As per the National Institute of Health Osteoporosis and Related Bone Diseases National Resource Center, “in the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass”. While, as per the NHS, “osteoporosis affects over 3 million people in the United Kingdom, wherein more than 500,000 people receive hospital treatment for fragility fractures every year as a result of osteoporosis”.

Similarly, as per DelveInsight’s analysis, the total diagnosed prevalent population of osteoporosis in the seven major markets was found to be 28,000,000+ cases in 2017, which is expected to increase in the coming years. In the EU5 countries, the total diagnosed prevalent osteoporosis population was found to be maximum in Germany, followed by Italy. In comparison, France had the lowest number of diagnosed prevalent cases of osteoporosis.

What are Risk Factors For Osteoporosis?

It is observed that females are found to be majorly affected by osteoporosis as compared to males.  Due to the ageing factor, after the age of 35, both men and women usually lose bone density every year. According to the International Osteoporosis Foundation, “globally 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime”. Apart from old age and gender, some of the significant risk factors for osteoporosis include genetics, low body weight, family history of osteoporosis, history of rheumatoid arthritis, personal history of fracture as an adult. Excessive alcohol consumption, cigarette smoking, sedentary lifestyle, lack of exercise, use of certain medications, and the lack of calcium and vitamin D also influence the occurrence of osteoporosis. 

What are the Most Common Symptoms Of Osteoporosis?

Osteoporosis is often called a “silent” disease, as the person may not have the symptoms for many years until a bone is broken. The symptoms appear in the later phase when bones have been weakened. Among various symptoms, the most common is the vertebral compression fracture or hip fracture. The compression fractures in the spine can lead to pain in the mid-back area. Receding gums, fracture from a fall,  loss of height, increased number of bed days, depression, etc., are some other common symptoms of Osteoporosis.

How is osteoporosis diagnosed?

The medical history of the patient is analysed initially for the diagnosis of osteoporosis. To further diagnose osteoporosis, a bone density test is conducted to measure how strong or weak the bones are. A dual-energy x-ray absorptiometry (DEXA) is a standard bone density test for Osteoporosis. A ‘DEXA scan’ is a type of x-ray of bones that uses a very low amount of radiation and provides valuable information about bone health.

What are the available treatment options for Osteoporosis?

The treatment of osteoporosis aims to treat and prevent fractures through various interventions. Similarly, dietary supplements are also recommended to strengthen weak bones. Majorly the treatment landscape is dominated by pharmacological therapies. According to the International Osteoporosis Foundation, “for patients at high risk, drug treatments are needed to effectively reduce the risk of broken bones due to osteoporosis. Treatments have been shown to reduce the risk of hip fracture by up to 40%, vertebral fractures by 30-70% and, with some medications, reduce the risk for non-vertebral fractures by 15-20%”.

Osteoporosis pharmacological therapies comprised of anti-resorptive agents (i.e., bisphosphonates, estrogen agonist/antagonists (EAAs), estrogens, calcitonin, and denosumab), anabolic agents (i.e., teriparatide and abaloparatide), and mixed agents (i.e., Romosozumab). Some other pharmacotherapies, major the anti-resorptive treatment options include estrogen replacement and selective estrogen receptor modulators, Similarly, dietary supplements such as calcium and vitamin D are also beneficial to patients affected by osteoporosis.

What lies ahead?

Osteoporosis, directly and indirectly, impacts the physical, mental health of the person and their families. The significant risk of death and chances of future complications such as a decrease in functional capacity, depression, spine fracture, also creates devastating impact. 

At present, the osteoporosis therapeutics market is dominated by biosimilars and generics, which are quite promising and potential for treatment. However, the current pipeline for osteoporosis holds only a limited number of products that are being developed by certain key players such as Amgen (Alendronate/Zoledronic Acid) and Haoma Medica (NaQuinate; Osteopura). In the coming years, the launch of emerging therapies is expected to improve the healthcare outcome for the patients affected with osteoporosis.

In recent years, osteoporosis treatment has observed significant therapeutic advances due to the greater understanding of bone morphology and better interpretation of the underlying mechanisms causing the disease. In the coming years, the rise in the number of prevalent cases, the expected launch of few therapies, increasing awareness about osteoporosis and risk factors related to osteoporosis is expected to drive the market growth. Similarly, the positive outcomes of the few products in the developmental stage by key players such as Amgen and Haoma Medica, the market is expected to witness a significant positive shift in the osteoporosis treatment scenario.