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

被引:299
作者
Kanis, J. A. [1 ,2 ]
Harvey, N. C. [3 ]
McCloskey, E. [1 ,4 ,5 ]
Bruyere, O. [6 ]
Veronese, N. [7 ]
Lorentzon, M. [2 ,8 ,9 ]
Cooper, C. [3 ,10 ]
Rizzoli, R. [11 ,12 ]
Adib, G. [13 ]
Al-Daghri, N. [14 ]
Campusano, C. [15 ,16 ]
Chandran, M. [17 ]
Dawson-Hughes, B. [18 ]
Javaid, K. [10 ]
Jiwa, F. [19 ]
Johansson, H. [1 ,2 ]
Lee, J. K. [20 ]
Liu, E. [2 ]
Messina, D. [21 ]
Mkinsi, O. [22 ]
Pinto, D. [23 ,24 ]
Prieto-Alhambra, D. [10 ,25 ,26 ,27 ]
Saag, K. [28 ]
Xia, W. [29 ,30 ]
Zakraoui, L. [31 ,32 ]
Reginster, J. -Y. [33 ]
机构
[1] Univ Sheffield, Sch Med, Ctr Metab Bone Dis, Beech Hill Rd, Sheffield S10 2RX, S Yorkshire, England
[2] Australian Catholic Univ, Mary McKillop Hlth Inst, Melbourne, Vic, Australia
[3] Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton, Hants, England
[4] MRC, Sheffield, S Yorkshire, England
[5] Arthrit Res UK Ctr Integrated Res Musculoskeletal, Sheffield, S Yorkshire, England
[6] Univ Liege, Collaborating Ctr Publ Hlth Aspects Musculoskelet, Dept Publ Hlth Epidemiol & Hlth Econ, WHO, Liege, Belgium
[7] CNR, Neurosci Inst, Aging Branch, Via Giustiniani 2, I-35128 Padua, Italy
[8] Univ Gothenburg, Dept Internal Med & Clin Nutr, Inst Med & Clin Nutr, Sahlgrenska Acad,Geriatr Med, Gothenburg, Sweden
[9] Sahlgrens Univ Hosp, Geriatr Med Clin, Region Vastra Gotaland, Gothenburg, Sweden
[10] Univ Oxford, NIHR Musculoskeletal Biomed Res Unit, Oxford, England
[11] Geneva Univ Hosp, Serv Bone Dis, Geneva, Switzerland
[12] Fac Med, Geneva, Switzerland
[13] Syrian Natl Osteoporosis Soc, Damascus, Syria
[14] King Saud Univ, Chair Biomarkers Chron Dis, Dept Biochem, Coll Sci, Riyadh, Saudi Arabia
[15] Clin Univ Los Andes, Santiago, Chile
[16] Univ Los Andes, Fac Med, Santiago, Chile
[17] Singapore Gen Hosp, ACADEMIA, Osteoporosis & Bone Metab Unit, Dept Endocrinol, 20 Coll Rd, Singapore 169856, Singapore
[18] Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA
[19] Osteoporosis Canada, Int Osteoporosis Fdn, Chair Comm Patients Soc, Toronto, ON, Canada
[20] Beacon Int Specialist Ctr, Petaling Jaya, Malaysia
[21] Cosme Argerich, Buenos Aires & Rheumatol Sect, IRO Med Res Ctr, Buenos Aires, DF, Argentina
[22] Ibn Rochd Univ Hosp, Dept Rheumatol, Casablanca, Morocco
[23] Marquette Univ, Dept Phys Therapy, Milwaukee, WI 53233 USA
[24] Northwestern Univ, Feinberg Sch Med, Dept Med Social Sci, Chicago, IL 60611 USA
[25] CIBERFes, GREMPAL Res Grp, Barcelona, Spain
[26] Inst Salud Carlos III, Idiap Jordi Gol, Barcelona, Spain
[27] Univ Autonoma Barcelona, Barcelona, Spain
[28] Univ Alabama Birmingham, Birmingham, AL USA
[29] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Key Lab Endocrinol, Dept Endocrinol,Minist Hlth, Shuaifuyuan 1, Beijing 100730, Peoples R China
[30] Peking Union Med Coll, Shuaifuyuan 1, Beijing 100730, Peoples R China
[31] Univ Tunis Manar, Serv Rhumatol, La Marsa, Tunisia
[32] Hop Mongi Slim, La Marsa, Tunisia
[33] Univ Liege, Dept Publ Hlth Epidemiol & Hlth Econ, Liege, Belgium
基金
英国工程与自然科学研究理事会; 英国医学研究理事会;
关键词
Anabolic agents; Fracture risk assessment; FRAX; Inhibitors of bone resorption; Treatment of osteoporosis; TRABECULAR BONE SCORE; POSTMENOPAUSAL WOMEN; INTERVENTION THRESHOLDS; HIP FRACTURE; OLDER-ADULTS; PREVENTION; EXERCISE; TIME; BMD; TERIPARATIDE;
D O I
10.1007/s00198-019-05176-3
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
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.
引用
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页码:1 / 12
页数:12
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