European guidance for the diagnosis and management of osteoporosis in postmenopausal women

• Published in: Osteoporosis international 2019-01, Vol.30 (1), p.3-44
• Main Authors: Kanis, J.A., Cooper, C., Rizzoli, R., Reginster, J.-Y.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Bone Density; Bone Density Conservation Agents - therapeutic use; Bone mineral density; Diagnosis; Diagnosis of osteoporosis; Dietary intake; Disease management; Endocrinology; Europe - epidemiology; Female; Fracture risk assessment; Fractures; FRAX; General & internal medicine; Health economics; Health risk assessment; Human health sciences; Humans; Life Style; Long-term effects; Medical diagnosis; Medicine; Medicine & Public Health; Médecine générale & interne; Orthopedics; Osteoarthritis; Osteoporosis; Osteoporosis, Postmenopausal - diagnosis; Osteoporosis, Postmenopausal - epidemiology; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis, Postmenopausal - therapy; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic Fractures - physiopathology; Osteoporotic Fractures - prevention & control; Position Paper; Post-menopause; Rheumatology; Risk assessment; Risk Assessment - methods; Risk Factors; Sciences de la santé humaine; Treatment of osteoporosis
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-018-4704-5

Summary Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. 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 2013. This manuscript updates these in a European setting. Methods Systematic reviews were updated. Results The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment. Conclusions A platform is provided on which specific guidelines can be developed for national use.