Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013

Compston, Juliet; Bowring, Claire; Cooper, Alun; Cooper, Cyrus; Davies, Christina; Francis, Roger M.; Kanis, John А.; Marsh, David; McCloskey, Eugène; Reid, David M.; Selby, Peter L.

doi:10.1016/j.maturitas.2013.05.013

Cited by 276 publications

(172 citation statements)

References 14 publications

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“…All 4 guideline statements utilize glucocorticoid dose and duration for treatment recommendations, while the ACR, IOF-ECTS, and EULAR guidelines also use the FRAX 10-year risk of major osteoporotic fracture in their treatment determinations (30,49,50,51). In 2013 the National Osteoporosis Guidelines Group (NOGG) in the UK released guidelines using the IOF-ECTS guidelines for Europe (52). Although the 5 recommendations (including NOGG) vary in details, they universally recommend treatment to reduce fractures in patients undergoing chronic glucocorticoid therapy who have an increased fracture risk.…”

mentioning

confidence: 99%

United States Adults Meeting 2010 American College of Rheumatology Criteria for Treatment and Prevention of Glucocorticoid‐Induced Osteoporosis

Overman

Toliver

Yeh

et al. 2014

Arthritis Care & Research

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Objective. The American College of Rheumatology (ACR) updated its guidelines on the prevention and treatment of glucocorticoid-induced osteoporosis (GIO) in 2010. An unknown proportion of US adults at risk of fracture due to glucocorticoid use would be recommended antiosteoporosis pharmaceutical (AOP) therapies based on the ACR guidelines. Methods. Using the 2005-2010 National Health and Nutrition Examination Survey (NHANES) data for postmenopausal women (PMW), and men age >50 years reporting current glucocorticoid use, we categorized individuals according to ACR criteria for low, medium, and high fracture risk (<10%, >10%, and >20%, respectively) and provided percentages of treatment recommendations for chronic (>90 days) medium and all high-risk patients. Results. Glucocorticoids were used by 1.66% of PMW and 1.65% of men age >50 years. Of these patients, 0.80% of PMW and 0.45% of men age >50 years were at high risk of fracture. A majority of PMW (81.2%) and men age >50 years (75.8%) were chronic glucocorticoid users. In patients for whom treatment recommendations could be made, 64.9% of PMW and 51.9% of men age >50 years would be recommended therapy, but only 28.4% of PMW and 9.7% of men age >50 years reported AOP use. Conclusion. Based on the NHANES (2005-2010) data, we estimate glucocorticoid use in >1.5 million US PMW and men age >50 years. Treatment would be recommended in at least 50% of this population based on the 2010 ACR guidelines. Self-reported AOP use was documented in <30%, suggesting a treatment gap in the management of GIO in the US before the guideline release.

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confidence: 99%

United States Adults Meeting 2010 American College of Rheumatology Criteria for Treatment and Prevention of Glucocorticoid‐Induced Osteoporosis

Overman

Toliver

Yeh

et al. 2014

Arthritis Care & Research

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“…This was against expectations, as within the FPF-SOP there was clear advice to the patients' orthogeriatricians/general practitioners to start anabolic agents. Presumably this reflects the relative high costs of these drugs, as well as the adherence of primary care physicians to the existing therapeutic guidelines [27].…”

Section: Discussionmentioning

confidence: 99%

“…Most patients in the study that were receiving anti-osteoporotic therapy used bisphosphonates (N = 57;65.5%), reflecting the existing mainstream therapeutic protocols in the United Kingdom [27]. In Loss of two levels of the pre-injury mobility status 5, 7.5% 7, 10.8%…”

Section: Discussionmentioning

confidence: 99%

Implementation of a standardized protocol to manage elderly patients with low energy pelvic fractures: can service improvement be expected?

Kanakaris

Greven

West

et al. 2017

International Orthopaedics (SICOT)

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Purpose The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bonequality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. Methods A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs. Multivariate regression analysis was used to determine prognostic factors. Study endpoints were the time-to-healing, length-of-stay, return to pre-injury mobility, union status, mortality and complications. Results A total of 132 elderly patients (≥65 years) admitted during the period 2012-2014 with FPFs were enrolled. Highenergy fractures, acetabular fractures, associated trauma affecting mobility, pathological pelvic lesions and operated FPFs were used as exclusion criteria. The majority of included patients were females (108/132; 81.8%), and the mean age was 85.8 years (range 67-108). Use of antiosteoporotics was associated with a shorter time of healing (p = 0.036). Patients treated according to the algorithm showed a significant protection against malunion (p < 0.001). Also, adherence to the algorithm allowed more patients to return to their pre-injury mobility status (p = 0.039). Conclusions The use of antiosteoporotic medication in elderly patients with fragility pelvic fractures was associated with faster healing, whilst the adherence to a structured clinical pathway led to less malunions and non-unions and return to pre-injury mobility state.

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“…The advent of absolute fracture risk calculators, such as the FRAX ® tool, provide a means to stratify fracture risk in the entire older population. The UK National Osteoporosis Guideline Group (NOGG) has based its guidance on FRAX ® , where an intervention threshold for 40 to 90 year olds is set at a risk equivalent to that expected in a woman with a prior fracture [79]. Many countries have subsequently adopted the approach taken by NOGG [9].…”

Section: Primary Fracture Preventionmentioning

confidence: 99%

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

et al. 2017

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-none for this submission. EVM -none for this submission. JAK and PJM have undertaken consultancy for governments, national osteoporosis societies, healthcare professional organisations and private sector companies relating to systematic approaches to fragility fracture care and prevention. JYR has no disclosures related to this work, and has received consultancy, lecture fees and grant support from Amgen, Analis, Asahi Kasei, Boehringer, Bristol Myers Squibb, Chiltern, Danone, Ebewee Pharma, Endocyte, Galapagos, GlaxoSmithKline, IBSAGenevrier, Lilly, Merck Sharp and Dohme, Merckle, Negma, Novartis, NovoNordisk, NPS, Nycomed-Takeda, Organon, Pfizer, PharmEvo, Radius Health, Roche, Rottapharm, Servier, Teijin, Teva, Theramex, Therabel, UCB, Will Pharma, Wyeth, Zodiac. NCWH has no disclosures related to this work, and has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. PJM serves as a consultant to the International Osteoporosis Foundation and received remuneration for his contribution to this manuscript. RR has received honoraria for participation in Advisory boards or speaker bureau fees from Danone, Labatec, Nestlé, and ObsEva. Introduction-This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into 4 distinct themes: Europe PMC Funders Group

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Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013

Cited by 276 publications

References 14 publications

United States Adults Meeting 2010 American College of Rheumatology Criteria for Treatment and Prevention of Glucocorticoid‐Induced Osteoporosis

United States Adults Meeting 2010 American College of Rheumatology Criteria for Treatment and Prevention of Glucocorticoid‐Induced Osteoporosis

Implementation of a standardized protocol to manage elderly patients with low energy pelvic fractures: can service improvement be expected?

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

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