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<i>Summary</i> <p>Post-hip fracture osteoprotective prescriptions in Spain rose significantly (40 to 58.5% at 1 month post-fracture, 2017–2024), mainly due to antiresorptives. Osteoanabolics remained underused, and treatment was disproportionately directed to healthier, younger patients. These findings highlight progress but reveal significant inequities, stressing the need for comprehensive, personalized strategies in secondary fracture prevention.</p> Background <p>Hip fractures in older adults are a major public health concern, associated with increased morbidity and mortality. Although osteoprotective prescriptions have risen in recent years, treatment rates remain below recommendations for secondary fracture prevention.</p> Objective <p>To examine temporal trends in osteoprotective treatment after hip fracture in Spain and to characterize patients receiving antiresorptive or osteoanabolic therapy.</p> Methods <p>We conducted a retrospective cohort study using data from the Spanish National Hip Fracture Registry (SNHFR) from 2017 to 2024. Patients aged ≥ 75 years were included. Osteoprotective treatment initiated within 1 month post-fracture was analyzed over time. Patient characteristics were compared according to treatment type.</p> Results <p>Of 73,016 patients identified, 58,987 met inclusion criteria. Osteoprotective treatment at 1 month increased from 40% in 2017 to 58.5% in 2024 (<i>p</i> &lt; 0.001), primarily due to increased antiresorptive use (37.3 to 54.3%). In contrast, osteoanabolic and dual therapies remained underused (&lt; 5% and ~ 1%, respectively). Treated patients were generally younger, more often female, functionally independent, cognitively intact, and had prior osteoprotective treatment. Among treated patients, those prescribed osteoanabolic were younger and more independent.</p> Conclusion <p>Osteoprotective prescription in SNHFR hospitals increased significantly between 2017 and 2024, by more than 46%. Despite this progress, osteoanabolic use remains limited, and treatment is disproportionately directed to healthier patients, diverging from guidelines that recommend therapy across all high-risk profiles. Strategies to ensure equitable and personalized secondary fracture prevention, particularly in frailer populations, are urgently needed.</p>

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Temporal trends in osteoprotective treatment after hip fracture in Spain: data from the Spanish National Hip Fracture Registry (2017–2024)

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Leonor Cuadra-Llopart,
  • Cristina González-Villaumbrosia,
  • Jose Manuel Cancio-Trujillo,
  • Teresa Casanova-Querol,
  • Patricia Ysabel Condorhuamán-Alvarado,
  • Teresa Pareja-Sierra,
  • Eugenia Sopena-Bert,
  • Pilar Sáez-López

摘要

Summary

Post-hip fracture osteoprotective prescriptions in Spain rose significantly (40 to 58.5% at 1 month post-fracture, 2017–2024), mainly due to antiresorptives. Osteoanabolics remained underused, and treatment was disproportionately directed to healthier, younger patients. These findings highlight progress but reveal significant inequities, stressing the need for comprehensive, personalized strategies in secondary fracture prevention.

Background

Hip fractures in older adults are a major public health concern, associated with increased morbidity and mortality. Although osteoprotective prescriptions have risen in recent years, treatment rates remain below recommendations for secondary fracture prevention.

Objective

To examine temporal trends in osteoprotective treatment after hip fracture in Spain and to characterize patients receiving antiresorptive or osteoanabolic therapy.

Methods

We conducted a retrospective cohort study using data from the Spanish National Hip Fracture Registry (SNHFR) from 2017 to 2024. Patients aged ≥ 75 years were included. Osteoprotective treatment initiated within 1 month post-fracture was analyzed over time. Patient characteristics were compared according to treatment type.

Results

Of 73,016 patients identified, 58,987 met inclusion criteria. Osteoprotective treatment at 1 month increased from 40% in 2017 to 58.5% in 2024 (p < 0.001), primarily due to increased antiresorptive use (37.3 to 54.3%). In contrast, osteoanabolic and dual therapies remained underused (< 5% and ~ 1%, respectively). Treated patients were generally younger, more often female, functionally independent, cognitively intact, and had prior osteoprotective treatment. Among treated patients, those prescribed osteoanabolic were younger and more independent.

Conclusion

Osteoprotective prescription in SNHFR hospitals increased significantly between 2017 and 2024, by more than 46%. Despite this progress, osteoanabolic use remains limited, and treatment is disproportionately directed to healthier patients, diverging from guidelines that recommend therapy across all high-risk profiles. Strategies to ensure equitable and personalized secondary fracture prevention, particularly in frailer populations, are urgently needed.