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CSA Working Groups and Research Projects

Ongoing Projects

Corticosteroid Induced Osteoporosis
This multinational project aims to improve awareness and treatment of corticosteroid-induced osteoporosis

Project co-ordinator: D. Messina

Epidemiology and Economic Aspects of Osteoporosis
This is a study in progress based on an international survey of the incidence of hip and vertebral fractures. It aims to determine the burden of osteoporotic fractures in women and men, by analysing risk factors, cost of fractures and cut off values in using BMD for diagnosis of osteoporosis.

Project co-ordinator: O. Johnell

European Group on Pharmacogenetics of Osteoporosis
The main objective of this project is to create a network of Centres interested in working on pharmacogenetics of osteoporosis, to create "genes cassettes" to be used in association studies by genotyping and haplotyping numerous patients within different ethnic groups, to prepare guidelines to be used in pharmacogenetic studies of osteoporosis taking into consideration technical and ethical issues.

Project co-ordinator: M.L. Brandi

European Vertebral Osteoporosis Study (EVOS)
Launched in 1989, EVOS, together with its subsequent prospective phase, the European Prospective Osteoporosis Study (EPOS), is the largest epidemiological study of osteoporosis in Europe, involving more than 17,000 men and women, aged 50-79, from 39 centers in 17 European countries. EVOS/EPOS provided data on the number of spinal and limb fractures in these countries. The studies have also assessed the role of several key lifestyle risk factors on the occurrence of fractures, the contribution of bone mineral density and evaluated morbidity and mortality following spinal fracture. To date, the two studies have resulted in close to 100 publications with more than 830 citations.

See list of publications

EPOS is now contributing to the GENEMOS EU shared cost action on the genetics of osteoporosis and the NEMO Thematic network on male osteoporosis.

Project co-ordinator: J. Reeve

Evaluation of Diagnostic, Treatment and Rehabilitation Procedures in Metabolic Bone Diseases in Children
About 133 studies have been collected to compare and interpret data with the objective to develop as a 1st priority the practical recommendations for densitometric measurements of children in clinical settings.

Project co-ordinator: R. Lorenc

Fracture Risk Assessment Tool
State-of-the-art scientific research now supports the use of proven therapies to prevent osteoporotic fractures based on the individual's probability of fracture as opposed to their bone density score alone. This new concept is currently being validated by a WHO working group (established in 1998) in collaboration with IOF and the (US) National Osteoporosis Foundation to ensure the accuracy and reproducibility of this concept. The goal is to develop a user-friendly fracture risk assessment tool for family physicians to use in patients of both sexes, all ages, ethnic groups and in all countries around the world.

Project co-ordinator: J. Kanis

List of publications as of October 2004 (PDF, 90 KB)

Guidelines for Assessment of Treatment of Osteoporosis
Set up to establish guidelines related to the ten-year fracture risk threshold at which it becomes cost effective to treat osteoporosis.

Project co-ordinator: J.A.Kanis

Publications supported by IOF:

  • Kanis JA, Dawson A, Oden A, Johnell O, de Laet C, Jonsson B (2001)
    Cost effectiveness of preventing hip fracture in the general female population.
    Osteoporosis International 12; 356-361.
  • Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jonsson B (2002)
    Intervention thresholds for osteoporosis.
    Bone 31; 26-31.

IOF-ISCD certification course for bone densitometry testing
Together with its member society, the International Society for Clinical Densitometry, IOF developed an international certification course for bone densitometry testing in collaboration with national societies.

Project coordinators: N. Watts and C. Glüer

Latin American Vertebral Osteoporosis Study (LAVOS)
This IOF-supported project covers 11 Latin American countries. The project has already produced a final protocol including standardization procedures for the questionnaire, X-Rays, Bone Densitometry, and an operation manual has been developed. An infrastructure has been set up with a morphometry center in Mexico, a DXA QA Center in Brazil and a Coordinating Center established in Mexico. A study was conducted in Mexico with a two-thirds result impact (407 cases survey out of 600 screened people).

Project co-ordinator: P. Clark

See feature article of November 2004

Longitudinal Changes in Risk Factors for Osteoporosis Due to Genetic and Lifestyle Influences
The objective of this project is to determine quantitatively the contribution of lifestyle factors (namely smoking, alcohol consumption and occupation) and genetic factors on age-related changes in BMD, bone size and geometry, and BTO, during 8 years of follow-up in an ethnically homogenous Chuvashian pedigrees. The present project was built up on previous studies in the Chuvasha population. Ethnically, Chuvasha are Europeans of Finno-Ugor tongue. They have lived for many generations in numerous small villages in the Volga region of Russia (Chuvasha Autonomous Republic). This population represents a very convenient object for the genetic epidemiological study of age related skeletal system degeneration in humans.

Project co-ordinators: G. Livshits and M. Seibel

Orthopaedic Surgeon Osteoporosis Survey
See Other Multinational scientific initiatives

In cooperation with the Bone & Joint Decade an orthopaedic surgeon osteoporosis survey was conducted in France, Germany, Italy, New Zealand, Spain and the UK with the assistance of the national orthopaedic associations during the second half of 2002. The survey, based on a US prototype, is designed to determine how orthopaedic surgeons currently manage patients with osteoporotic fractures. The survey results support the need to improve fragility fracture services and provides a helpful tool for the implementation of the World Orthopaedic Osteoporosis Organization (WOOO) recommendations for care to reduce the risk of future fractures. The survey findings are triggering many actions by orthopaedic associations at a national level to improve care of fragility fracture patients. To date guidelines have been produced by orthopaedic associations in Germany, Spain and the UK and are expected in France during 2005.

At a European level the survey and recommendations for care were presented at a 90- minute symposium during the EFORT (European Orthopaedic Association) 2003 in Helsinki. Click here for International Osteoporosis Survey Aggregated Findings, as presented by Dr Karsten Dreinhöfer, Bone & Joint Decade 2000-2010 and specific national results and recommendations for France, Germany, Italy, Spain and the UK. See press release issued on June 9, 2003 Since then presentations have also taken place at other international congresses including the 2004 World Congress on Osteoporosis and the 2005 American Academy of Orthodpaedic Surgeons Congress.

Additionally numerous articles have been published within the participating countries. Coverage in international publications includes the Journal of Bone and Joint Surgery, Vol. 86-B, No. 7, Septemer 2004, "Orthopaedic surgeons and fragility fractures" and Osteoporosis International (in press), "Multinational survey of osteoporotic fracture management."

The survey has since been conducted or is planned to be conducted in other locations including Australia, the Middle East, Mexico and Latin America.

Project co-ordinator for IOF: M. Anderson

Osteoporosis Clinical Practice Consensus Guidelines for Orthopaedic Surgeons
In partnership with orthopaedic associations including the American Academy of Orthopaedic Surgeons, the European Federation of Orthopaedic Surgeons and Traumatologists (EFORT) and the (US) National Osteoporosis Foundation, work commenced on osteoporosis clinical practical consensus guidelines for orthopaedic surgeons led by Professor Olof Johnell on behalf of IOF. As the presence of a fracture increases the risk of future fractures two- to five-fold within one year it is vital that orthopaedic surgeons recognise fractures caused by osteoporosis and initiate appropriate treatment.
Click here for further information and to download CD

Project coordinator: O. Johnell

Improving Care of the Fragility Fracture Patient: Recommendations for Orthopaedic Surgeons

In partnership with orthopaedic associations, including the European Federation of Orthopaedic Surgeons and Traumatologists (EFFORT), the American Academy of Orthopaedic Surgeons (AAOS), the Bone and Joint Decade, and the International Society for Fracture Repair (ISFR), work began on developing recommendations for improving care of fragility fracture patients. These recommendations are targeted primarily at orthopaedic surgeons and fracture management teams. There is strong evidence that having a fracture increases the risk of future fracture two- to five-fold. Orthopaedic surgeons are often the first, and sometimes the only, physicians seen by patients who have suffered a fracture. Thus, orthopedists have a unique opportunity to help prevent the dramatic decline in quality of life subsequent to a fragility fracture. These recommendations are designed to help orthopedists recognize those fractures that are caused by osteoporosis and initiate appropriate treatment.

Project coordinators: M.L. Bouxsein, O. Johnell and D. Marsh

Bouxsein ML, Kaufman J, Tosi L, Cummings S, Lane J and Johnell O (2004) Recommendations for optimal care of the fragility fracture patient to reduce the risk of future fractures. Journal of the American Academy of Orthopaedic Surgeons. (in press)

Osteoporosis Education Programme to Improve the Recognition and Reporting of Vertebral Fractures by Radiologists
Recent studies show that worldwide a substantial percentage of mild and moderate vertebral fractures are not diagnosed in radiology reports. The identification of patients with a vertebral fracture is important because the presence of a vertebral fracture greatly increases the risk of future fractures. To improve the recognition and reporting of vertebral fracture by radiologists, IOF, in partnership with the European Society of Skeletal Radiologists and national radiologist groupings began this programme in 2002. See educational material

Project co-ordinators: P.D. Delmas and H.K. Genant

Grigoryan M, Guermazi A, Roemer FW, Delmas PD, Genant HK (2003) Recognizing and reporting osteoporotic vertebral fractures. Eur Spine J. Suppl 2:S104-12.

Lenchik L, Rogers LF, Delmas PD, Genant HK (2004) Diagnosis of osteoporotic vertebral fractures: importance of recognition and description by radiologists. Am J Roentgenol. 183:949-58.

Paget's Disease of Bone
To obtain recent data and estimate changes in the age-and-sex specific prevalence of different European regions, this working group will carry out a radiographic survey in the same 13 towns of 9 European countries in which a similar study was performed 20 years ago.

Project co-ordinator: G. Poor

Quality of Life
Led by Professor Paul Lips, work commenced in 1993 on an osteoporosis disease-specific, thoroughly validated questionnaire to measure the health-related quality of life of people with spine fractures. This questionnaire, in various languages, is available here on the IOF website. In 2000 work began on a second validated questionnaire to measure the decline in health-related quality of life for people suffering from wrist fractures, which is available in more than six languages.

Project co-ordinator: P. Lips

Working group to promote basic, clinical and economic research in the field of osteoarthritis
A CSA working group was created to promote basic, clinical and economic research in the field of osteoarthritis, another common musculoskeletal disease in the elderly. This working group has built strong partnerships with Osteoarthritis Research Society International (OARSI) and the International League of Associations in Rheumatology (ILAR). A series of symposia, the European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis have been established with the most recent held in Nice in November 2003.

List of Publications as of October 2004 (PDF, 27 KB)

Project coordinator: J-Y. Reginster

CSA Working Groups, Research Projects and Publications
Completed projects
Multinational Partnership Initatives

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