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Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK

      Abstract

      In 1999 and 2000 the Royal College of Physicians published guidelines for the prevention and treatment of osteoporosis [

      Royal College of Physicians. Osteoporosis: clinical guidelines for the prevention and treatment. London: Royal College of Physicians; 1999.

      ; Royal College of Physicians and Bone and Tooth Society of Great Britain. Update on pharmacological interventions and an algorithm for management. London, UK: Royal College of Physicians; 2000.;

      Royal College of Physicians. Glucocorticoid-induced osteoporosis. Guidelines on prevention and treatment. Bone and Tooth Society of Great Britain, National Osteoporosis Society and Royal College of Physicians. London, UK: Royal College of Physicians 2000.

      ]. Since then, there have been significant advances in the field of osteoporosis including the development of new techniques for measuring bone mineral density, improved methods of assessing fracture risk and new treatments that have been shown to significantly reduce the risk of fractures. Against this background, the National Osteoporosis Guideline Group (NOGG), in collaboration with many Societies in the UK, have updated the original guidelines [

      Royal College of Physicians, National Osteoporosis Guideline Group on behalf of the Bone Research Society, British Geriatrics Society, British Orthopaedic Association, British Society of Rheumatology, National Osteoporosis Society, Osteoporosis 2000, Osteoporosis Dorset, Primary Care Rheumatology Society, Society for Endocrinology. Osteoporosis. Clinical guideline for prevention and treatment, Executive Summary. University of Sheffield Press; 2008.

      , Osteoporosis Dorset, Primary Care Rheumatology Society, Society for Endocrinology. Osteoporosis. Clinical guideline for prevention and treatment, Executive Summary. University of Sheffield Press; 2008], a practical summary of which is detailed below. The management algorithms are underpinned by a health economic analysis applied to the epidemiology of fracture in the UK.

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      References

      1. Royal College of Physicians. Osteoporosis: clinical guidelines for the prevention and treatment. London: Royal College of Physicians; 1999.

      2. Royal College of Physicians and Bone and Tooth Society of Great Britain. Update on pharmacological interventions and an algorithm for management. London, UK: Royal College of Physicians; 2000.

      3. Royal College of Physicians. Glucocorticoid-induced osteoporosis. Guidelines on prevention and treatment. Bone and Tooth Society of Great Britain, National Osteoporosis Society and Royal College of Physicians. London, UK: Royal College of Physicians 2000.

      4. Royal College of Physicians, National Osteoporosis Guideline Group on behalf of the Bone Research Society, British Geriatrics Society, British Orthopaedic Association, British Society of Rheumatology, National Osteoporosis Society, Osteoporosis 2000, Osteoporosis Dorset, Primary Care Rheumatology Society, Society for Endocrinology. Osteoporosis. Clinical guideline for prevention and treatment, Executive Summary. University of Sheffield Press; 2008.

        • Kanis J.A.
        • on behalf of the World Health Organization Scientific Group
        Assessment of osteoporosis at the primary health-care level. Technical Report.
        WHO Collaborating Centre, University of Sheffield, UK2008
        • Kanis J.A.
        • Johnell O.
        • Oden A.
        • Johansson H.
        • McCloskey E.
        FRAX® and the assessment of fracture probability in men and women from the UK.
        Osteoporos Int. 2008; 19: 385-397
      5. Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A, et al. Case finding for the management of osteoporosis with FRAX® – assessment and intervention thresholds for the UK. Osteoporos Int., 2008 Nov 20th [Epub ahead of print] PMID: 19020922.

      Glossary

      BMD
      bone mineral density
      BMI
      body mass index; weight (kg)/height (m2)
      CRF
      clinical risk factor for fractures due to osteoporosis
      DXA
      dual energy X-ray absorptiometry
      FRAX®
      the WHO fracture risk assessment tool
      SD
      standard deviation (of BMD measurements)
      T-score
      the number of standard deviations that a BMD measurement lies above or below the average value for young healthy women