Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

• Published in: Osteoporosis international Vol. 31; no. 1; pp. 1 - 12
• Main Authors: Kanis, J. A., Harvey, N. C., McCloskey, E., Bruyère, O., Veronese, N., Lorentzon, M., Cooper, C., Rizzoli, R., Adib, G., Al-Daghri, N., Campusano, C., Chandran, M., Dawson-Hughes, B., Javaid, K., Jiwa, F., Johansson, H., Lee, J. K., Liu, E., Messina, D., Mkinsi, O., Pinto, D., Prieto-Alhambra, D., Saag, K., Xia, W., Zakraoui, L., Reginster, J. -Y.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.01.2020; Springer Nature B.V
• Subjects: Aged; Algorithms; Anabolic agents; bmd; Bone Density; Endocrinology; Endocrinology & Metabolism; Endocrinology and Diabetes; Endokrinologi och diabetes; exercise; Female; Fracture risk assessment; Fractures; FRAX; hip fracture; Hormone replacement therapy; Humans; Inhibitors of bone; intervention thresholds; Management; Medicine; Medicine & Public Health; Middle Aged; older-adults; Orthopedics; Osteoarthritis; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - epidemiology; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic Fractures - prevention & control; Position Paper; Post-menopause; postmenopausal women; prevention; resorption; Rheumatology; Risk Assessment; Risk Factors; teriparatide; time; trabecular bone score; Treatment of osteoporosis; Treatment of osteoporosis; FRAX; Anabolic agents; Fracture risk assessment; Inhibitors of bone resorption
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-019-05176-3

Summary Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures. Introduction The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach. Methods Clinical perspective and updated literature search. Results The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis. Conclusions A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.