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Objectives: To estimate the preferences of osteoporotic patients for medication attributes, and analyse data from seven European countries., Methods: A discrete choice experiment was conducted in Belgium, France, Ireland, the Netherlands, Spain, Switzerland and the UK. Patients were asked to choose repeatedly between two hypothetical unlabelled drug treatments (and an opt-out option) that varied with respect to four attributes: efficacy in reducing the risk of fracture, type of potential common side effects, and mode and frequency of administration. In those countries in which patients contribute to the cost of their treatment directly, a fifth attribute was added: out-of-pocket cost. A mixed logit panel model was used to estimate patients' preferences., Results: In total, 1124 patients completed the experiment, with a sample of between 98 and 257 patients per country. In all countries, patients preferred treatment with higher effectiveness, and 6-monthly subcutaneous injection was always preferred over weekly oral tablets. In five countries, patients also preferred a monthly oral tablet and yearly i.v. injections over weekly oral tablets. In the three countries where the out-of-pocket cost was included as an attribute, lower costs significantly contributed to the treatment preference. Between countries, there were statistically significant differences for 13 out of 42 attribute/level interactions., Conclusion: We found statistically significant differences in patients' preferences for anti-osteoporosis medications between countries, especially for the mode of administration. Our findings emphasized that international treatment recommendations should allow for local adaptation, and that understanding individual preferences is important if we want to improve the quality of clinical care for patients with osteoporosis., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com)

Vertebral fractures due to osteoporosis are a common skeletal disorder affecting the mobility of the patients, although little is known about the relationship between spinal kinematics and osteoporotic fracture. The purpose of this study was to characterize the motions of the thoracolumbar spine affected by osteoporotic vertebral fracture at level T12 and compare the results with those of non-fracture osteoporosis subjects. We examined the continuous segmental kinematics of the vertebrae, and describe the segmental motion of the spine when a fracture at T12 is present. Fluoroscopy sequences of the thoracolumbar spines during sagittal and lateral flexion were collected from 16 subjects with osteoporosis of their spine (6 with vertebral fractures at T12, 10 without a fracture). Vertebrae T10-L2 in each frame of the sequences were landmarked. Kinematic parameters were calculated based on the landmarks and motion graphs were constructed. Compared to the control subjects who did not have a fracture, fracture subjects had a more asymmetric lateral range of motion (RoM) and required a longer time to complete certain phases of the motion cycle which are parameterized as lateral flexion ratio and percentage of motion cycle, respectively. Prolonged deflection was more frequently found from the fracture group. Characterizing the motions of the fractured vertebra together with its neighboring vertebrae with these kinematic parameters is useful in quantifying the dysfunction and may be a valuable aid to tracking progress of treatment.

Osteoporosis is a major public health problem because of its association with fractures. Prevention of osteoporosis is of utmost importance in reducing the health and human costs related to the disease. Bone mass in adult life is determined partly by the peak bone mass accrued as a young adult, and partly by the subsequent rate of bone loss. Understanding the determinants of premenopausal bone mineral status is important in order to develop a prevention strategy. Non-modifiable risk factors are heredity and race/ethnicity. Potentially modifiable are non-genetic host factors such as intrauterine programming, body build, reproductive factors, diseases and drugs, and environmental factors such as diet, exercise and smoking and alcohol. [ABSTRACT FROM AUTHOR]