Varied programme will highlight topical issues in osteoporosis

President of the Irish Osteoporosis Society, Prof Moira O’Brien, spoke to the Medical Independent about the Society’s upcoming annual conference for healthcare professionals.

The Irish Osteoporosis Society (IOS) is a charity dedicated to reducing the incidence of osteoporosis and promoting good bone health. Osteoporosis, which affects an estimated 300,000 people in Ireland, is more common in females who have gone through the menopause, and it can also affect men and children. Furthermore, athletes who overtrain, people who develop eating disorders, or a combination of both, can be at high-risk of developing osteoporosis when they are young. 

The Society’s Annual Medical Conference for Health Professionals, which is a key event in its calendar, will be held virtually on Saturday 22 October. The conference will feature a varied range of presentations from expert speakers on topical issues relating to osteoporosis. 

President of the Society, Prof Moira O’Brien, told the Medical Independent the virtual conference will be an opportune way for healthcare professionals to keep their knowledge up to date on this important issue. 

“It is the commonest bone disease worldwide, but it is preventable, and it is treatable [for the majority],” stated Prof O’Brien. 

The rate of bone re-modelling is affected by numerous factors including sex hormones, vitamin D and parathyroid hormone. Prof O’Brien emphasised that identifying the cause (s) of osteoporosis, treating the cause(s), and ensuring ongoing patient monitoring, are paramount. In Ireland, there were examples of good practice in prevention, treatment and management of osteoporosis, but there was major room for improvement, indicated Prof O’Brien. 

She noted, as an example, patients undergoing elective hip arthroplasty without a thorough investigation to exclude osteoporosis, as the disease is likely to impact the success of the procedure (due to the poor quality of bone for the replacement joint to adhere to). According to Prof O’Brien, if osteoporosis is identified by DXA scan, the patient can build up their bone strength prior to surgery and increase the chances of a successful operation. 

Awareness 

The IOS annual conference seeks to raise awareness about the disease and its optimal prevention, treatment, and management. The meeting aims to include healthcare professionals from across disciplines including medicine, nursing, physiotherapy, nutrition, and paramedicine. 

Prof O’Brien said there would be ample opportunity for healthcare professionals to raise queries with the expert speakers during the day. “After each group of talks, there is at least half an hour of questions and answers, so people can speak to the experts and get their point of view,” she commented. “The speakers we have are all excellent and [attendees] will learn a lot.” 

Prof O’Brien said there would be ample opportunity for healthcare professionals to raise queries with the expert speakers during the day 

The day will begin with Prof O’Brien’s opening address, where she is expected to highlight the importance of exercise in prevention of osteoporosis, among other matters. The opening session will be chaired by Dr Martin Coyne, GP with a special interest in osteoporosis. The first talk will focus on hyperparathyroidism, delivered by Dr Kevin McCarroll, Consultant Physician and Geriatrician, Bone Health Unit, St James’s Hospital, Dublin. Hyperparathyroidism is a condition in which one or more of the parathyroid glands become overactive and secrete too much parathyroid hormone. 

“If the parathyroid is overactive, then it takes the calcium from the bones, and you are more likely to get kidney stones, but you are also more likely to fracture,” outlined Prof O’Brien. “It is so important to do these investigations. You need to find out what the person’s vitamin D level is (most assume if a patient is taking vitamin D, they are absorbing it, but gluten sensitivity can affect absorption), because if you have low vitamin D levels that increases the levels of parathyroid hormone….” 

Falls 

The next presentation of the morning is titled ‘Preventing falls and fractures post-Covid-19 – Time to focus on muscles’ by Prof Bernard Walsh, Consultant Physician and Geriatrician, Bone Health Unit, St James’s Hospital and Trinity College Dublin. 

Prof O’Brien said building muscle strength can prevent bone loss and reduce the risk of falls and fractures. She also noted that many people do not realise that most fractures occur in the osteopenia range, therefore a significant cohort of people are at risk of fracture. 

The second part of the conference will be chaired by Dr Richard Tobin, GP with a special interest in osteoporosis and musculoskeletal medicine. Women’s health will be the focus of a talk by Ms Aoife Ni Eochaidh, Chartered Physiotherapist and Clinical Specialist Physiotherapist, Women’s and Men’s Health and Continence, Bon Secours Consultants Clinic, Galway. This will be followed by a presentation titled ‘License to kill – The double Os of bone health’ by Dr Derek Bennett, President of the Irish American Orthopaedic Society and Member of the European Board of Orthopaedic and Trauma Surgeons. 

The last presentation in this session will focus on considerations around commencement of denosumab and strategies that are required by clinicians if discontinuation is going to occur. The presentation will be delivered by Dr Rosaleen Lannon, Consultant Physician in Geriatric Medicine, St James’s Hospital. The beneficial effects of denosumab, a twice-yearly injectable monoclonal antibody, are lost rapidly if treatment is discontinued abruptly. Last year’s IOS conference heard that osteoporosis patients on denosumab must be adequately educated on the risks of treatment non-compliance, such as rapid rebound bone loss and increased fracture risk. 

Exercise 

The day’s final session, chaired by Prof Bernard Walsh, will commence with a talk on exercise and chronic diseases from Prof Niall Moyna, Professor of Clinical Exercise Physiology, School of Health and Human Performance, Dublin City University. 

Prof O’Brien said Prof Moyna will discuss the importance of exercise programmes, which are an “essential part” of treatment for osteoporosis. She underlined that exercise programme should be tailored to the individual in this respect. 

The final presentation will focus on osteoporosis and osteonecrosis of the jaw (ONJ) (speaker to be confirmed). ONJ may uncommonly occur in patients taking antiresorptive medications that are used for osteoporosis. Good oral hygiene and dental care lower the risk of developing ONJ. 

This condition is “very rare”, said Prof O’Brien, “but because it is so rare and so unusual” there is a significant amount of misinformation about its management. Therefore, this presentation is expected to bring clarity to the subject. 

The conference will conclude with abstract award presentations (in the categories of Young Investigator Award; Best Overall Scientific Abstract; Most Interesting Clinical Case; and Best Poster). 

For healthcare professionals who cannot attend the virtual conference, Prof O’Brien said there is comprehensive information about the disease – including risk factors and treatments – on the Society’s website (www.irishosteoporosis.ie).