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

Osteoporos Int. 2019 Jan;30(1):3-44. doi: 10.1007/s00198-018-4704-5. Epub 2018 Oct 15.

Abstract

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.

Keywords: Bone mineral density; Diagnosis of osteoporosis; FRAX; Fracture risk assessment; Health economics; Treatment of osteoporosis.

Publication types

  • Practice Guideline

MeSH terms

  • Absorptiometry, Photon / methods
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use
  • Europe / epidemiology
  • Female
  • Humans
  • Life Style
  • 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
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Bone Density Conservation Agents