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Archives of Osteoporosis
Erschienen in: Archives of Osteoporosis 1/2021

01.12.2021 | Position Paper

Diagnostic, treatment, and follow-up of osteoporosis—position statement of the Latin American Federation of Endocrinology

verfasst von: O. Gómez, A. P. Talero, M. B. Zanchetta, M. Madeira, C. A. Moreira, C. Campusano, A. M. Orjuela, S. Cerdas P, M. P. de la Peña-Rodríguez, A. A. Reza, C. Velazco, B. Mendoza, L. R. Uzcátegui, P. N. Rueda

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2021

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Abstract

Summary

The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region.

Introduction

There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap.

Methods

An experts’ panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions.

Results

Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems.

Conclusions

Through a process based on recognized methodological tools, FELAEN’s position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.
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Literatur
1.
Aranco N, Stampini M, Ibarrarán P, Medellín N (2018) Panorama de envejecimiento y dependencia en América Latina y el Caribe
2.
Comisión Económica para América Latina y el Caribe (CEPAL) (2019) Anuario Estadístico de América Latina y el Caribe, 2018. Santiago
3.
Clark P, Denova-Gutiérrez E, Zerbini C, Sanchez A, Messina O, Jaller JJ et al (2018) FRAX-based intervention and assessment thresholds in seven Latin American countries. Osteoporos Int 29(3):707–15PubMedCrossRef
4.
Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR et al (2009) The prevalence of radiographic vertebral fractures in Latin American countries: The Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20(2):275–82PubMedCrossRef
5.
International Osteoporosis Foundation (2012) Latin America Regional Audit
6.
Silva DMW, Lazaretti-Castro M, Freitas Zerbini CA, de, Szejnfeld VL, Eis SR, Borba VZC. (2019) Incidence and excess mortality of hip fractures in a predominantly Caucasian population in the South of Brazil. Arch Osteoporos. 14(1):47PubMedCrossRef
7.
Ministerio de Salud Pública de Uruguay (2015) Decreto N° 38/015
8.
Albergaria B-H, Chalem M, Clark P, Messina OD, Pereira RMR, Vidal LF (2018) Consensus statement: osteoporosis prevention and treatment in Latin America—current structure and future directions. Arch Osteoporos. 13(1):90PubMedPubMedCentralCrossRef
9.
Laurell AC, Giovanella L (2018) Health policies and systems in Latin America. En: Oxford Research Encyclopedia of Global Public Health. Oxford University Press
10.
Aziziyeh R, Amin M, Habib M, Garcia Perlaza J, Szafranski K, McTavish RK et al (2019) The burden of osteoporosis in four Latin American countries: Brazil, Mexico, Colombia, and Argentina. J Med Econ 22(7):638–44PubMedCrossRef
11.
12.
Grupo de Actualización de la Guía Metodológica para el desarrollo de Guías de Práctica Clínica, con Evaluación Económica en el SGSSS Colombiano (2014) Guía Metodológica para la elaboración de Guías de Práctica Clínica con Evaluación Económica en el Sistema General de Seguridad Social en Salud Colombiano. Bogotá
13.
Schunemann HJ, Wiercioch W, Etxeandia I, Falavigna M, Santesso N, Mustafa R et al (2014) Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise. Can Med Assoc J 186(3):E123-42CrossRef
14.
Alper BS, Haynes RB (2016) EBHC pyramid 5.0 for accessing preappraised evidence and guidance. Evid Based Med 21(4):123–5PubMedCrossRef
15.
16.
Grimmer K, Dizon JM, Milanese S, King E, Beaton K, Thorpe O et al (2014) Efficient clinical evaluation of guideline quality: development and testing of a new tool. BMC Med Res Methodol. 14(1):63PubMedPubMedCentralCrossRef
17.
Humphrey-Murto S, Varpio L, Gonsalves C, Wood TJ (2017) Using consensus group methods such as Delphi and Nominal Group in medical education research. Med Teach 39(1):14–9PubMedCrossRef
18.
National Institute of Arthritis and Musculoskeletal and Skin Diseases, European Foundation for Osteoporosis and Bone Disease, American National Osteoporosis Foundation. Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med. 1991;90(1):107–10.
19.
European Foundation for Osteoporosis and Bone Disease, National Osteoporosis Foundation, National Institute of Arthritis and Musculoskeletal and Skin Diseases. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94(6):646–50.
20.
National Institute for Health and Clinical Excellence (NICE). Osteoporosis: Assessing the risk of fragility fracture. 2012.
21.
Royal Australian College of General Practitioners, Osteoporosis Australia. Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age, 2nd edition. 2017.
22.
Naves Díaz M, Bernardino Díaz López J, GÓmez Alonso C, Altadill Arregui A, Rodríguez Rebollar A, B. Cannata Andía J. Estudio de incidencia de fracturas osteoporóticas en una cohorte mayor de 50 años durante un período de 6 años de seguimiento. Med Clin (Barc). 2000;115(17):650–3.
23.
Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R et al (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 27(4):1281–386PubMedPubMedCentralCrossRef
24.
Camacho PM, Petak SM, Binkley N, Clarke BL, Harris ST, Hurley DL et al (2016) American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the diagnosis and treatment. Endocr Pract. 22(Supplement 4):1–42PubMedCrossRef
25.
Mendoza B, Ronco ÁL. Estacionalidad de la vitamina D plasmática: su importancia en la clínica y en la salud . Vol. 32, Revista Médica del Uruguay . scielouy ; 2016. p. 80–6.
26.
Hoel DG, Berwick M, de Gruijl FR, Holick MF (2016) The risks and benefits of sun exposure 2016. Dermatoendocrinology 8(1):e1248325CrossRef
27.
Religi A, Backes C, Chatelan A, Bulliard J-L, Vuilleumier L, Moccozet L et al (2019) Estimation of exposure durations for vitamin D production and sunburn risk in Switzerland. J Expo Sci Environ Epidemiol. 29(6):742–52PubMedCrossRef
28.
Lewiecki EM. Osteoporosis: Clinical Evaluation. En: Feingold K, Anawalt B, Boyce A, editores. Endotext. South Darthmouth: MDText.com, Inc.; 2000.
29.
Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res. 9(8):1137–41PubMedCrossRef
30.
Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A et al (2020) American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis - 2020 Update. Endocr Pract 26(5):564–570PubMedCrossRef
31.
32.
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 312(7041):1254–9PubMedPubMedCentralCrossRef
33.
Dhiman P, Andersen S, Vestergaard P, Masud T, Qureshi N. Does bonemineral density improve the predictive accuracy of fracture risk assessment?A prospective cohort study in Northern Denmark. BMJ Open. 2018;8(4):e018898.
34.
35.
Borges JLC, Sousa da Silva M, Ward RJ, Diemer KM, Yeap SS, Lewiecki EM. Repeating Vertebral Fracture Assessment: 2019 ISCD Official Position. J Clin Densitom. 2019;22(4):484–8.
36.
Rosen HN, Vokes TJ, Malabanan AO, Deal CL, Alele JD, Olenginski TP et al (2013) The Official Positions of the International Society for Clinical Densitometry: Vertebral Fracture Assessment. J Clin Densitom 16(4):482–488PubMedCrossRef
37.
Silva BC, Broy SB, Boutroy S, Schousboe JT, Shepherd JA, Leslie WD (2015) Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 2: Trabecular Bone Score. J Clin Densitom 18(3):309–330PubMedCrossRef
38.
Martineau P, Leslie WD, Johansson H, Oden A, McCloskey EV, Hans D et al (2017) Clinical Utility of Using Lumbar Spine Trabecular Bone Score to Adjust Fracture Probability: The Manitoba BMD Cohort. J Bone Miner Res 32(7):1568–1574PubMedCrossRef
39.
Adami G, Arioli G, Bianchi G, Brandi ML, Caffarelli C, Cianferotti L et al (2020) Radiofrequency echographic multi spectrometry for the prediction of incident fragility fractures: A 5-year follow-up study. Bone. 134:115297PubMedCrossRef
40.
Di Paola M, Gatti D, Viapiana O, Cianferotti L, Cavalli L, Caffarelli C et al (2019) Radiofrequency echographic multispectrometry compared with dual X-ray absorptiometry for osteoporosis diagnosis on lumbar spine and femoral neck. Osteoporos Int. 30(2):391–402PubMedCrossRef
41.
Greco A, Pisani P, Conversano F, Soloperto G, Renna MD, Muratore M et al (2017) Ultrasound Fragility Score: An innovative approach for the assessment of bone fragility. Measurement 101:236–242CrossRef
42.
Diez-Perez A, Brandi ML, Al-Daghri N, Branco JC, Bruyère O, Cavalli L et al (2019) Radiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art—outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Mus. Aging Clin Exp Res. 31(10):1375–89PubMedPubMedCentralCrossRef
43.
Shepstone L, Lenaghan E, Cooper C, Clarke S, Fong-Soe-Khioe R, Fordham R et al (2018) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet 391(10122):741–747PubMedCrossRef
44.
Pramyothin P, Holick MF (2012) Vitamin D supplementation. Curr Opin Gastroenterol 28(2):139–150PubMedCrossRef
45.
Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA et al (2012) IOM Committee Members Respond to Endocrine Society Vitamin D Guideline. J Clin Endocrinol Metab 97(4):1146–1152PubMedPubMedCentralCrossRef
46.
Aguiar Moreira C, dos S. Ferreira C, Madeira M, Carvalho Silva B, Setsuo Maeda S, Cidade Batista M, et al. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/ Laboratory Medicine (SBPC). Arch Endocrinol Metab. 2020;1–17.
47.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al (2011) Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 96(7):1911–1930PubMedCrossRef
48.
Institute of Medicine, Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. Ross A, Taylor C, Yaktine A, editores. Washington, D.C.: National Academies Press; 2011.
49.
Avenell A, Mak JC, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014.
50.
Kahwati LC, Weber RP, Pan H, Gourlay M, LeBlanc E, Coker-Schwimmer M et al (2018) Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults. JAMA. 319(15):1600PubMedCrossRef
51.
Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, Staehelin HB, Meyer OW, Theiler R, et al. Monthly high-dose vitamin D treatment for the prevention of functional decline. JAMA Intern Med. 2016;176(2):175
52.
Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D (2019) Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 104(5):1595–622PubMedCrossRef
53.
Zhou J, Ma X, Wang T, Zhai S (2016) Comparative efficacy of bisphosphonates in short-term fracture prevention for primary osteoporosis: a systematic review with network meta-analyses. Osteoporos Int. 27(11):3289–300PubMedCrossRef
54.
55.
Barrionuevo P, Kapoor E, Asi N, Alahdab F, Mohammed K, Benkhadra K et al (2019) Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis. J Clin Endocrinol Metab. 104(5):1623–30PubMedCrossRef
56.
Bone HG, Wagman RB, Brandi ML, Brown JP, Chapurlat R, Cummings SR et al (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5(7):513–523PubMedCrossRef
57.
Cummings SR, Ferrari S, Eastell R, Gilchrist N, Jensen J-EB, McClung M, et al. Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized placebo-controlled FREEDOM trial and its extension. J Bone Miner Res. 2018;33(2):190–8.
58.
Díez-Pérez A, Marin F, Eriksen EF, Kendler DL, Krege JH, Delgado-Rodríguez M (2019) Effects of teriparatide on hip and upper limb fractures in patients with osteoporosis: a systematic review and meta-analysis. Bone 120:1–8PubMedCrossRef
59.
Eastell R, Nickelsen T, Marin F, Barker C, Hadji P, Farrerons J et al (2009) Sequential treatment of severe postmenopausal osteoporosis after teriparatide: final results of the randomized, controlled European Study of Forsteo (EUROFORS)*. J Bone Miner Res 24(4):726–736PubMedCrossRef
60.
Chen C-H, Elsalmawy AH, Ish-Shalom S, Lim S-J, Al-Ali NS, Cunha-Borges JL et al (2019) Study description and baseline characteristics of the population enrolled in a multinational, observational study of teriparatide in postmenopausal women with osteoporosis: the Asia and Latin America Fracture Observational Study (ALAFOS). Curr Med Res Opin. 35(6):1041–9PubMedCrossRef
61.
Simpson EL, Martyn-St James M, Hamilton J, Wong R, Gittoes N, Selby P et al (2020) Clinical effectiveness of denosumab, raloxifene, romosozumab, and teriparatide for the prevention of osteoporotic fragility fractures: a systematic review and network meta-analysis. Bone. 130:115081PubMedCrossRef
62.
Liu Y, Cao Y, Zhang S, Zhang W, Zhang B, Tang Q et al (2018) Romosozumab treatment in postmenopausal women with osteoporosis: a meta-analysis of randomized controlled trials. Climacteric. 21(2):189–95PubMedCrossRef
63.
Food and Drugs Administration - FDA. Highlights of prescribing information - Evenity [Internet]. 2019 [citado 30 de mayo de 2020]. Disponible en: www.​fda.​gov/​medwatch.
64.
Hodis HN, Mack WJ, Henderson VW, Shoupe D, Budoff MJ, Hwang-Levine J et al (2016) Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 374(13):1221–31PubMedPubMedCentralCrossRef
65.
Sanchez-Rodriguez D, Bergmann P, Body JJ, Cavalier E, Gielen E, Goemaere S, et al. The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women. Maturitas. 2020.
66.
Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 30(1):3–44PubMedCrossRef
67.
Al Anouti F, Taha Z, Shamim S, Khalaf K, Al Kaabi L, Alsafar H (2019) An insight into the paradigms of osteoporosis: from genetics to biomechanics. Bone Reports. 11:100216PubMedPubMedCentralCrossRef
68.
Nishizawa Y, Miura M, Ichimura S, Inaba M, Imanishi Y, Shiraki M et al (2019) Executive summary of the Japan Osteoporosis Society Guide for the Use of Bone Turnover Markers in the Diagnosis and Treatment of Osteoporosis (2018 Edition). Clin Chim Acta 498:101–7PubMedCrossRef
69.
Lorentzon M, Branco J, Brandi ML, Bruyère O, Chapurlat R, Cooper C et al (2019) Algorithm for the use of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis. Adv Ther. 36(10):2811–24PubMedPubMedCentralCrossRef
70.
Wu C-H, Chang Y-F, Chen C-H, Lewiecki EM, Wüster C, Reid I, et al. Consensus statement on the use of bone turnover markers for short-term monitoring of osteoporosis treatment in the Asia-Pacific Region. J Clin Densitom. 2019.
71.
Shoback D, Rosen CJ, Black DM, Cheung AM, Murad MH, Eastell R. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society guideline update. J Clin Endocrinol Metab. 2020;105(3).
72.
European Medicines Agency - EMA. Summary of product characteristics - Terrosa. 2017.
73.
Food and Drugs Administration - FDA. Highlights of prescribing information - Bonsity. 2019.
74.
75.
Aziziyeh R, Perlaza JG, Saleem N, Guiang H, Szafranski K, McTavish RK (2021) Benefits of fracture liaison services (FLS) in four Latin American countries: Brazil, Mexico, Colombia, and Argentina. J Med Econ 24(1):96–102PubMedCrossRef
Metadaten
Titel
Diagnostic, treatment, and follow-up of osteoporosis—position statement of the Latin American Federation of Endocrinology
verfasst von
O. Gómez
A. P. Talero
M. B. Zanchetta
M. Madeira
C. A. Moreira
C. Campusano
A. M. Orjuela
S. Cerdas P
M. P. de la Peña-Rodríguez
A. A. Reza
C. Velazco
B. Mendoza
L. R. Uzcátegui
P. N. Rueda
Publikationsdatum
01.12.2021
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2021
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-021-00974-x

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