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Funding: UCB funded this study, This study demonstrates a substantial and persistent anti-osteoporosis treatment gap in men and women ≥50 years old who sustained major osteoporotic fracture(s) between 2005 and 2014 in Denmark. This was not substantially reduced by including hospital-administered anti-osteoporosis treatments. Strengthened post-fracture organization of care and secondary fracture prevention is highly needed. The purpose of this study was to evaluate the Danish anti-osteoporosis treatment gap from 2005 to 2014 in patients sustaining a major osteoporotic fracture (MOF), and to assess the impact of including hospital-administered anti-osteoporosis medications (AOM) on the treatment gap among these patients. In this retrospective, registry-based study, we included men and women aged 50 years or older and living in Denmark, who sustained at least one MOF between 2005 and 2014. We applied a repeated cross-sectional design to generate cohorts of patients sustaining a first MOF, hip, vertebral, humerus, or forearm fracture, respectively, within each calendar year. We evaluated the treatment gap as the proportion of patients within each cohort not receiving treatment with AOM within 1 year of the fracture. Hospital-administered AOM was identified by SKS code. The treatment gap among MOF patients decreased from 85% in 2005 to 79% in 2014. The gap was smaller among hip and vertebral fracture patients as compared to humerus and forearm fracture patients, and it was smaller in women than in men. The use of hospital-administered AOM was relatively uncommon, with a maximum of 0.9% of MOF patients initiating hospital-administered AOM (in 2012). We observed substantial variations in this proportion between fracture types and gender. Hospital-administered AOM was most commonly used among vertebral fracture patients. A significant treatment gap among patients sustaining a major osteoporotic fracture was present throughout our analysis, and including hospital-administered AOM did not significantly impr

Objetivos: La diabetes mellitus tipo 2 (DM2) y la osteoporosis son dos procesos prevalentes en las consultas de atención primaria y estrechamente relacionados. Paradójicamente, a pesar de que los pacientes DM2 presentan una mayor masa ósea, presentan un mayor riesgo de fractura. Los objetivos de este estudio es estimar la asociación entre la presencia de DM2 incidente y la incidencia de fractura osteoporótica en población española, y secundariamente analizar la relación entre DM2 y la mortalidad en los primeros años tras la aparición de una fractura osteoporótica. Método: Estudio de cohortes de base poblacional. Para el sub-estudio 1 se seleccionaron los pacientes con DM2 incidente entre 2006-1013 de la base de datos SIDIAP y se emparejaron con 2 pacientes no diabéticos. Para el sub-estudio 2 se seleccionaron pacientes ≥50 años con DM2 entre 2006-2013 y se emparejaron con 2 sujetos no diabéticos. Se recogió información sobre factores de riesgo, fracturas incidentes, mortalidad y factores confusores. Mediante modelos de supervivencia de Fine and Gray se analizó la asociación entre DM2 y riesgo de fractura de cadera. Para el sub-estudio 2 se calcularon tasas de mortalidad post-fractura y mediante modelos de regresión de Cox ajustados se calculó el riesgo de mortalidad según la presencia o no de DM2. Resultados: Se identificaron 58.483 pacientes con DM2 incidente y 113.448 pacientes no diabéticos, seguidos durante una mediana (rango inter-cuartil) de 2,63 (2,93) años. En los primeros años (hasta 6 años) después de la aparición de la enfermedad, 444/58.483 (0,8%) pacientes con DM2 sufrieron una fractura femoral vs 776/113.448 (0,7%) en los pacientes no diabéticos. El SHR ajustado fue de 1,20 [IC 95% 1,06 - 1,35]. En sub-estudio 2 s e identificaron un total de 166.106 pacientes DM2 y 332.212 no diabéticos, de los cuales 11.066 (6,66%) DM2 y 21.564 (6.49%) no diabéticos sufrieron una fractura, y éstos se incluyeron para el análisis principal. La tasa de mortalidad post-fr, Aims: Type 2 diabetes mellitus (T2DM) and osteoporosis are two highly prevalent long-term comorbidities. Paradoxically, although T2DM patients have a higher bone mass, they present an increased risk of fracture. The objectives of this study are to estimate the association between the presence of T2DM and the incidence of osteoporotic fracture in the Spanish population and secondarily to analyze the relationship between T2DM and all-cause mortality after an osteoporotic fracture. Methods: Population-based cohort study. For sub-study 1, patients with incidentT2DM between 2006-1013 from the SIDIAP database were selected and matched with 2 non-diabetic patients. For sub-study 2 T2DM patients ≥50 years between 2006-2013 were selected and were matched with 2 non-diabetic subjects. Information about risk factors, incident fractures, mortality and confounding factors were collected. Survival models of Fine and Gray were fitted to model the association between T2DM and hip fracture risk. Post-fracture mortality rates were calculated for sub-study 2 and Cox regression models were fitted to calculate mortality risk according to T2DM status. Results: 58,483 patients with incident T2DM and 113,448 non-diabetic patients were selected, followed by a median (interquartile range) of 2.63 (2.93) years. In the early years (up to 6) following disease onset, 444/58,483 (0.8%) T2DM patients sustained a hip fracture, compared to 776/113,448 (0.7%) matched non-diabetic controls. The adjusted SHR was 1.20 [95% CI 1.06 - 1.35]. In sub-study 2, a total of 166,106 T2DM and 332,212 non-diabetic patients were identified, of whom 11,066 (6.66%) T2DM and 21.564 (6.49%) non-diabetic patients sustained a fracture, and were then included for the main analysis Mortality rate post-fracture was 53.93 per 1,000 person-years. More than 50% of the observed deaths occurred during the first two years after a fracture, with the higher proportion of them seen in the first year following a hip fracture. The adj