ArticleArchives of osteoporosis2026
Temporal trends in osteoprotective treatment after hip fracture in Spain: data from the Spanish National Hip Fracture Registry (2017-2024).
Article in Archives of osteoporosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
backgroundHip 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.
objectiveTo examine temporal trends in osteoprotective treatment after hip fracture in Spain and to characterize patients receiving antiresorptive or osteoanabolic therapy.
methodsWe 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.
resultsOf 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.
conclusionOsteoprotective 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.
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