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Osteoporosis International
Erschienen in: Osteoporosis International 1/2020

Open Access 13.11.2019 | Position Paper

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

verfasst von: J. A. Kanis, N. C. Harvey, E. McCloskey, O. Bruyère, N. Veronese, M. Lorentzon, C. Cooper, R. Rizzoli, G. Adib, N. Al-Daghri, C. Campusano, M. Chandran, B. Dawson-Hughes, K. Javaid, F. Jiwa, H. Johansson, J. K. Lee, E. Liu, D. Messina, O. Mkinsi, D. Pinto, D. Prieto-Alhambra, K. Saag, W. Xia, L. Zakraoui, J. -Y. Reginster

Erschienen in: Osteoporosis International | Ausgabe 1/2020

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Abstract

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.
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Literatur
1.
Kanis JA, Cooper C, Rizzoli R, Reginster J-Y, Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF) (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44PubMed
2.
Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2019) Executive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Aging Clin Exp Res 31:15–17PubMed
3.
Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2019) Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Calcif Tissue Int 104:235–238PubMedPubMedCentral
4.
Johnell O, Oden A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12:207–214PubMed
5.
Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Pettersen C, De Laet C, Jonsson B (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15:175–179PubMed
6.
Nymark T, Lauritsen JM, Ovesen O, Röck ND, Jeune B (2006) Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study. Osteoporos Int 17:1353–1357PubMed
7.
Giangregorio LM, Leslie WD (2010) Manitoba bone density program. Time since prior fracture is a risk modifier for 10-year osteoporotic fractures. J Bone Miner Res 25:1400–1405PubMed
8.
van Geel TACM, van Helden S, Geusens PP, Winkens B, Dinant G-J (2009) Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis 68:99–102PubMed
9.
Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E, Sigurdsson G, Kanis JA (2017) Imminent risk of fracture after fracture. Osteoporos Int 28:775–780PubMed
10.
Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner-Pammer A, Lespessailles E, Minisola S, Body JJ, Geusens P, Möricke R, López-Romero P (2018) Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 391(10117):230–240PubMed
11.
Saag KG, Petersen J, Brandi ML, Karaplis AC, Lorentzon M, Thomas T, Maddox J, Fan M, Meisner PD, Grauer A (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377:1417–1427PubMed
12.
Barrionuevo P, Kapoor E, Asi N, Alahdab F, Mohammed K, Benkhadra K, Almasri J, Farah W, Sarigianni M, Muthusamy K, Al Nofal A, Haydour Q, Wang Z, Murad MH (2019) Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis. J Clin Endocrinol Metab 104:1623–1630PubMed
13.
Lou S, Lv H, Yin P, Li Z, Tang P, Wang Y (2019) Combination therapy with parathyroid hormone analogs and antiresorptive agents for osteoporosis: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 30:59–70PubMed
14.
15.
Russow G, Jahn D, Appelt J, Märdian S, Tsitsilonis S, Keller J (2018) Anabolic therapies in osteoporosis and bone regeneration. Int J Mol Sci 26:20(1)
16.
Khosla S, Hofbauer LC (2017) Osteoporosis treatment: recent developments and ongoing challenges. Lancet Diabetes Endocrinol 5:898–907PubMedPubMedCentral
17.
18.
Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La Croix A, McCloskey E, Mellstrom D, Melton LJ 3rd, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van Staa T, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046PubMed
19.
Kanis JA, Harvey NC, Cooper C, Johansson H, Odén A, McCloskey EV, the Advisory Board of the National Osteoporosis Guideline Group (2016) A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 11:25PubMedPubMedCentral
20.
Clark P, Denova-Gutiérrez E, Zerbini C, Sanchez A, Messina O, Jaller JJ, Campusano C, Orces CH, Riera G, Johansson H, Kanis JA (2018) FRAX-based intervention and assessment thresholds in seven Latin American countries. Osteoporos Int 29:707–715PubMed
21.
Kanis JA, EV MC, Johansson H, Strom O, Borgstrom F, Oden A, the National Osteoporosis Guideline Group (2008) Case finding for the management of osteoporosis with FRAX® - assessment and intervention thresholds for the UK. Osteoporos Int 19:1395–1408PubMed
22.
Tosteson AN, Melton LJ 3rd, Dawson-Hughes B et al (2008) Cost-effective osteoporosis treatment thresholds: the United States perspective. Osteoporos Int 19:437–447PubMedPubMedCentral
23.
Kanis JA, Stevenson M, McCloskey EV, Davis S, Lloyd-Jones M (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess; 11: iii–iv, ix–xi, 1–231
24.
Shepstone L, Lenaghan E, Cooper C, Clarke S, Fong-Soe-Khioe R, Fordham R, Gittoes NJ, Harvey I, Harvey N, Heawood A, Holland R, Howe A, Kanis J, Marshall T, O'Neill T, Peters T, Redmond N, Torgerson D, Turner D, McCloskey E (2018) Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet 391(10122):741–747PubMed
25.
Kanis JA, Johansson H, Oden A, McCloskey EV (2011) Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int 22:809–816PubMed
26.
Leslie WD, Lix LM, Johansson H, Odén A, McCloskey E, Kanis JA (2011) Spine-hip discordance and fracture risk assessment: a physician-friendly FRAX enhancement. Osteoporos Int 22:839–847PubMed
27.
Johansson H, Kanis JA, Odén A, Leslie WD, Fujiwara S, Glüer CC, Kroger H, LaCroix AZ, Lau E, Melton LJ 3rd, Eisman JA, O'Neill TW, Goltzman D, Reid DM, McCloskey E (2014) Impact of femoral neck and lumbar spine BMD discordances on FRAX probabilities in women: a meta-analysis of international cohorts. Calcif Tissue Int 95:428–435PubMedPubMedCentral
28.
McCloskey EV, Odén A, Harvey NC, Leslie WD, Hans D, Johansson H, Barkmann R, Boutroy S, Brown J, Chapurlat R, Elders PJM, Fujita Y, Glüer CC, Goltzman D, Iki M, Karlsson M, Kindmark A, Kurumatani N, Kwok T, Leung J, Lippuner K, Ljunggren Ö, Lorentzon M, Mellström D, Merlijn T, Oei L, Ohlsson C, Pasco J, Rivadeneira F, Rosengren B, Sornay-Rendu E, Szulc P, Tamaki J, Kanis JA (2016) A meta-analysis of trabecular bone score in fracture risk prediction and its dependence on FRAX. J Bone Miner Res 31:940–948PubMed
29.
Leslie WD, Johansson H, Kanis JA, Lamy O, Odén A, McCloskey EV, Hans D (2014) Lumbar spine texture enhances 10-year fracture probability assessment. Osteoporos Int 25:2271–2277PubMed
30.
Leslie WD, Shevroja E, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D (2018) Risk-equivalent T-score adjustment using lumbar spine trabecular bone score (TBS): the Manitoba BMD Registry. Osteoporos Int 29:751–758PubMedPubMedCentral
31.
Leslie WD, Lix LM, Morin SN, Johansson H, Odén A, McCloskey EV, Kanis JA (2015) Adjusting hip fracture probability in men and women using hip axis length: the Manitoba Bone Density Database. J Clin Densitom 19:326–331PubMed
32.
Masud T, Binkley N, Boonen S, Hannan MT, on behalf of the FRAX Position Conference members (2011) Can falls and frailty be used in FRAX? J Clin Densitom 14:194–204PubMed
33.
Johansson H, Odén A, Lorentzon M, McCloskey E, Kanis JA, Harvey NC, Karlsson MK, Mellstrom D (2015) Is the Swedish FRAX model appropriate for immigrants to Sweden? Osteoporos Int 26:2617–2622PubMed
34.
Leslie WD, Rubin MR, Schwartz AZ, Kanis JA (2012) Perspective: diabetes and bone. J Bone Miner Res 27:2231–2237PubMed
35.
Leslie WD, Johansson H, McCloskey EV, Harvey NC, Kanis JA, Hans D (2018) Comparison of methods for improving fracture risk assessment in diabetes: the Manitoba BMD Registry. J Bone Miner Res 33:1923–1930PubMed
36.
Whitlock RH, Leslie WD, Shaw J, Rigatto C, Thorlacius L, Komenda P, Collister D, Kanis JA, Tangri N (2019) The Fracture Risk Assessment Tool (FRAX®) predicts fracture risk in patients with chronic kidney disease. Kidney Int 95:447–454PubMed
37.
Kanis JA, Johansson H, Harvey NC, Lorentzon M, Liu E, Borgström F, McCloskey EV (2019) Correspondence in response to OSIN-D-18-00831 quantifying imminent risk. Osteoporos Int 30:525–526PubMed
38.
National Institute for Health and Care Excellence (NICE) (2017) Bisphosphonates for treating osteoporosis. Technology appraisal guidance 464. National Institute for Health and Care Excellence, London
39.
Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, Hope S, Kanis JA, McCloskey EV, KES P, Reid DM, Selby P, Thompson F, Thurston A, Vine N, The National Osteoporosis Guideline Group (NOGG) (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12:43PubMedPubMedCentral
40.
Kanis JA, Rizzoli R, Cooper C, Reginster J-Y (2014) Challenges for the development of bone forming agents in Europe. Calcif Tissue Int 94:469–473PubMed
41.
Beck BR, Daly RM, Singh MA, Taaffe DR (2017) Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport 20:438–445PubMed
42.
Giangregorio L, El-Kotob R (2017) Exercise, muscle, and the applied load-bone strength balance. Osteoporos Int 28:21–33PubMed
43.
44.
Jensen AL, Lomborg K, Wind G, Langdahl BL (2014) Effectiveness and characteristics of multifaceted osteoporosis group education - a systematic review. Osteoporos Int 25:1209–1224PubMed
45.
Morfeld JC, Vennedey V, Müller D, Pieper D, Stock S (2017) Patient education in osteoporosis prevention: a systematic review focusing on methodological quality of randomised controlled trials. Osteoporos Int 28:1779–1803PubMed
46.
Zhou X, Deng H, Shen X, Lei Q (2018) Effect of balance training on falls in patients with osteoporosis: a systematic review and meta-analysis. J Rehabil Med 50:577–581PubMed
47.
48.
Kemmler W, von Stengel S, Kohl M (2017) Exercise frequency and fracture risk in older adults -how often is enough? Curr Osteoporos Rep 15:564–570PubMed
49.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR (2017) Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 51:1750–1758PubMed
50.
Tricco AC, Thomas SM, Veroniki AA, Hamid JS, Cogo E, Strifler L, Khan PA, Robson R, Sibley KM, MacDonald H, Riva JJ, Thavorn K, Wilson C, Holroyd-Leduc J, Kerr GD, Feldman F, Majumdar SR, Jaglal SB, Hui W, Straus SE (2017) Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. JAMA 318:1687–1699PubMedPubMedCentral
51.
McCloskey E, Kanis JA, Johansson H, Harvey N, Odén A, Cooper A, Cooper C, Francis R, Reid D, Selby P, Davies C, Bowring C, Compston J (2015) FRAX-based assessment and intervention thresholds--an exploration of thresholds in women aged 50 years and older in the UK. Osteoporos Int 26:2091–2099PubMed
52.
Lekamwasam S, Adachi JD, Agnusdei D, Bilezikian J, Boonen S, Borgström F, Cooper C, Diez Perez A, Eastell R, Hofbauer L, Kanis JA, Langdahl BL, Lesnyak O, Lorenc R, McCloskey E, Messina OD, Napoli N, Obermayer-Pietsch B, Ralston SH, Sambrook PN, Silverman S, Sosa M, Stepan J, Suppan G, Wahl DA, Compston JE, for the Joint IOF-ECTS GIO Guidelines Working Group (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23:2257–2276PubMed
53.
Dretakis KE, Dretakis EK, Papakitsou EF, Psarakis S, Steriopoulos K (1998) Possible predisposing factors for the second hip fracture. Calcif Tissue Int 62:366–369PubMed
54.
Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323PubMed
55.
Ryg J, Rejnmark L, Overgaard S, Brixen K, Vestergaard P (2009) Hip fracture patients at risk of second hip fracture: a nationwide population-based cohort study of 169,145 cases during 1977-2001. J Bone Miner Res 24:1299–1307PubMed
56.
Banefelt J, Åkesson KE, Spångéus A, Ljunggren O, Karlsson L, Ström O, Ortsäter G, Libanati C, Toth E (2019) Risk of imminent fracture following a previous fracture in a Swedish database study. Osteoporos Int 30:601–609PubMedPubMedCentral
57.
Balasubramanian A, Zhang J, Chen L, Wenkert D, Daigle SG, Grauer A, Curtis JR (2019) Risk of subsequent fracture after prior fracture among older women. Osteoporos Int 30:79–92PubMed
58.
Kanis JA, Johansson H, Odén A, Harvey NC, Gudnason V, Sanders K, Sigurdsson G, Siggeirsdottir K, Borgström F, McCloskey EV (2018) Characteristics of recurrent fractures. Osteoporos Int 29:1747–1757PubMedPubMedCentral
59.
Johansson H, Siggeirsdottir K, Harvey NC, McCloskey EV, Gudnason V, Sigurdsson G, Lorentzon M, Liu E, Kanis JA (2019) Adjusting FRAX for imminent risk. Osteoporos Int, abstract in press.
60.
Cosman F, Nieves JW, Dempster DW (2017) Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res 32(198–202):270
61.
Kanis JA, Cooper C, Rizzoli R, Abrahamsen B, Al-Daghri NM, Brandi ML, Cannata-Andia J, Cortet B, Dimai HP, Ferrari S, Hadji P, Harvey NC, Kraenzlin M, Kurth A, McCloskey E, Minisola S, Thomas T, Reginster JY (2017) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int 28:2023–2034PubMedPubMedCentral
62.
Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2018) Review of the guideline of the American College of Physicians on the treatment of osteoporosis. Osteoporos Int 29:1505–1510PubMedPubMedCentral
63.
Leder BZ, Tsai JN, Neer RM, Uihlein AV, Wallace PM, BurnettBowie SA (2016) Response to therapy with teriparatide, denosumab, or both in postmenopausal women in the DATA (denosumab and teriparatide administration) study randomized controlled trial. J Clin Densitom 19:346–351PubMed
64.
Bone HG, Cosman F, Miller PD, Williams GC, Hattersley G, Hu MY, Fitzpatrick LA, Mitlak B, Papapoulos S, Rizzoli R, Dore RK, Bilezikian JP, Saag KG (2018) ACTIVExtend: 24 months of alendronate after 18 months of abaloparatide or placebo for postmenopausal osteoporosis. J Clin Endocrinol Metab 103:2949–2957
Metadaten
Titel
Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures
verfasst von
J. A. Kanis
N. C. Harvey
E. McCloskey
O. Bruyère
N. Veronese
M. Lorentzon
C. Cooper
R. Rizzoli
G. Adib
N. Al-Daghri
C. Campusano
M. Chandran
B. Dawson-Hughes
K. Javaid
F. Jiwa
H. Johansson
J. K. Lee
E. Liu
D. Messina
O. Mkinsi
D. Pinto
D. Prieto-Alhambra
K. Saag
W. Xia
L. Zakraoui
J. -Y. Reginster
Publikationsdatum
13.11.2019
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 1/2020
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-05176-3

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