UK clinical guideline for the prevention and treatment of osteoporosis - PubMed (original) (raw)

doi: 10.1007/s11657-017-0324-5. Epub 2017 Apr 19.

A Cooper 2, C Cooper 3, N Gittoes 4, C Gregson 5, N Harvey 3, S Hope 6, J A Kanis 7, E V McCloskey 8, K E S Poole 9, D M Reid 10, P Selby 11, F Thompson 12, A Thurston 12, N Vine 9; National Osteoporosis Guideline Group (NOGG)

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UK clinical guideline for the prevention and treatment of osteoporosis

J Compston et al. Arch Osteoporos. 2017 Dec.

Abstract

Introduction: In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over.

Methods: Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence.

Results: Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds.

Conclusion: The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

Keywords: Fracture; Guideline; NOGG; Osteoporosis.

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Conflict of interest statement

Juliet Compston received advisory and speaking fees from Gilead, related to development of tenofovir alafenamide.Nic Vine, Fizz Thompson, Anne Thurston, Celia Gregson and Peter Selby have no conflict of interest. David Reid is a shareholder of GlaxoSmithKline and Astra Zeneca. Alun Cooper received advisory or speaking fees from Consilient Health and Internis. Cyrus Cooper received honoraria, consultancies and speaking fees from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda and UCB. John Kanis received consultancies/speaking fees from AgNovos healthcare, Amgen, D3A, Lilly, Medimaps, Unigene, Radius Health, Pfizer, Servier and Takeda. Research support is from Asahi, Amgen, GSK, Lilly, Medtronic, Novadrtis, Pfizer, Sanofi-Aventis, Servier and Warner Chilcott. Neil Gittoes received advisory fees from Lilly, Amgen, Shire, Prostrakan, Stirling Anglian, Internis and Alexion. Sally Hope received speaking fees from Amgen and Consilient Health. Nick Harvey received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. Eugene McCloskey received consultancies, honoraria and speaking fees from ActiveSignal, Alliance for Better Bone Health, Amgen, Bayer, Boehringer Ingelheim, Consilient Healthcare, Eli Lilly, GE Lunar, GSK, Hologic, Internis, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Synexus, Tethys, and UCB. Research funding is from the Alliance for Better Bone Health, Amgen, Arthritis Research UK, EPSRC, Internis, Medical Research Council and NIHR. Ken Poole received advisory and speaking fees from Amgen, UCB, Celltech and Lilly and research funding from Lilly and Amgen.

Figures

Fig. 1

Fig. 1

Algorithm for monitoring of long-term bisphosphonate therapy in postmenopausal women

Fig. 2

Fig. 2

Graph showing assessment and intervention thresholds in the UK for major osteoporotic fracture probability. The dotted line represents the intervention threshold while the assessment thresholds are shown within the amber area [141]. BPs bisphosphonates, GCs glucocorticoids

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