Abstract
Introduction
In November 2009, the “3rd Summit on Osteoporosis—Central and Eastern Europe (CEE)” was held in Budapest, Hungary. The conference aimed to tackle issues regarding osteoporosis management in CEE identified during the second CEE summit in 2008 and to agree on approaches that allow most efficient and cost-effective diagnosis and therapy of osteoporosis in CEE countries in the future.
Discussion
The following topics were covered: past year experience from FRAX® implementation into local diagnostic algorithms; causes of secondary osteoporosis as a FRAX® risk factor; bone turnover markers to estimate bone loss, fracture risk, or monitor therapies; role of quantitative ultrasound in osteoporosis management; compliance and economical aspects of osteoporosis; and osteoporosis and genetics. Consensus and recommendations developed on these topics are summarised in the present progress report.
Conclusion
Lectures on up-to-date data of topical interest, the distinct regional provenances of the participants, a special focus on practical aspects, intense mutual exchange of individual experiences, strong interest in cross-border cooperations, as well as the readiness to learn from each other considerably contributed to the establishment of these recommendations. The “4th Summit on Osteoporosis—CEE” held in Prague, Czech Republic, in December 2010 will reveal whether these recommendations prove of value when implemented in the clinical routine or whether further improvements are still required.
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References
O’Neil TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018
Strom O, Borgstrom F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Ceder L, Thorngren KG, Sernbo I, Jonsson B (2008) Long-term cost and effect on quality of life of osteoporosis-related fractures in Sweden. Acta Orthop 79:269–280
Kanis JA, Johnell O, Oden A, Borgstrom F, Zethraeus N, De Laet C, Jonsson B (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15:20–26
Lorenc RS, Resch H (2009) Management of osteoporosis in Central and Eastern Europe (CEE): conclusions of the “2nd Summit on Osteoporosis—CEE”, 21–22 November 2008, Warsaw, Poland. Arch Osteoporos 4:1–8
Franek E, Karczmarewicz E, Misiorowski W et al (2009) Treatment benefits evaluation in osteoporosis—position of the Summit International Conference on Osteoporosis—Central Eastern Europe held 21–22 November 2008, Warsaw, Poland. Bone 44:S374–S375
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259
McCloskey EV, Johansson H, Oden A, Kanis JA (2009) From relative risk to absolute fracture risk calculation: the FRAX® algorithm. Curr Osteoporos Rep 7:77–83
Kanis JA, McCloskey EV, Johansson H, Oden A, Ström O, Borgström F (2010) Development and use of FRAX® in osteoporosis. Osteoporos Int 21((Suppl 2)):S407–S413
Pluskiewicz W, Adamczyk P, Franek E, Leszczynski P, Sewerynek E, Wichrowska H, Napiorkowska L, Kostyk T, Stuss M, Stepien-Klos W, Golba KS, Drozdzowska B (2010) Ten-year probability of osteoporotic fracture in 2012 Polish women assessed by FRAX® and nomogram by Nguyen et al.—conformity between methods and their clinical utility. Bone 46:1661–1667
Tałałaj M (2009) Bone fracture risk at secondary osteoporoses. Third Central European Congress on Osteoporosis and Osteoarthritis, Krakow, Poland. Abstract L33
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 285:320–323
Genant HK, Delmas PD, Chen P, Jiang Y, Eriksen EF, Dalsky GP, Marcus R, San Martin J (2007) Severity of vertebral fracture reflects deterioration of bone microarchitecture. Osteoporos Int 18:69–76
Chen P, Krege JH, Adachi JD, Prior JC, Tenenhouse A, Brown JP, Papadimitropoulos E, Kreiger N, Olszynski WP, Josse RG, Goltzman D (2009) Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. J Bone Miner Res 24:495–502
Bone Health and Osteoporosis: a report of the surgeon general 2004. U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD, US; http://www.surgeongeneral.gov/library/bonehealth/Executive_Summary.html#Chapter8AssessingtheRiskofBoneDiseaseandFracture, accessed 2 July 2010
Kanis JA, Johnell O, Oden A, Johansson H, De Laet C, Eisman JA, Fujiwara S, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16:155–162
van Staa TP, Leufkens HG, Cooper C (1991) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777–787
Meenan RF, Kazis LE, Anthony JM, Wallin BA (1991) The clinical and health status of patients with recent-onset rheumatoid arthritis. Arthritis Rheum 34:761–765
Kanis JA, Burlet N, Cooper C, Delmas PD, ReginsterJ-Y BF, Rizzoli R (2008) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 19:399–428
Greenspan SL, Resnick NM, Parker RA (2005) Early changes in biochemical markers of bone turnover are associated with long-term changes in bone mineral density in elderly women on alendronate, hormone replacement therapy, or combination therapy: a three-year, double-blind, placebo-controlled, randomized clinical trial. J Clin Endocrinol Metab 90:2762–2767
Chen P, Satterwhite JH, Licata AA, Lewiecki EM, Sipos AA, Misurski DM, Wagman RB (2005) Early changes in biochemical markers of bone formation predict BMD response to teriparatide in postmenopausal women with osteoporosis. J Bone Miner Res 20:962–970
Stepan JJ, Zikán V (2003) Calcitonin load test to assess the efficacy of salmon calcitonin. Clin Chim Acta 336:49–55
Holzer G, Noske H, Lang T, Holzer L, Willinger U (2005) Soluble cathepsin K: a novel marker for the prediction of nontraumatic fractures? J Lab Clin Med 146:13–17
Palomba S, Orio F Jr, Russo T, Falbo A, Tolino A, Manguso F, Nunziata V, Mastrantonio P, Lombardi G, Zullo F (2005) BsmI vitamin D receptor genotypes influence the efficacy of antiresorptive treatments in postmenopausal osteoporotic women. A 1-year multicenter, randomized and controlled trial. Osteoporos Int 16:943–952
Hellman J, Käkönen SM, Matikainen MT, Karp M, Lövgren T, Väänänen HK, Pettersson K (1996) Epitope mapping of nine monoclonal antibodies against osteocalcin: combinations into two-site assays affect both assay specificity and sample stability. J Bone Miner Res 11:1165–1175
Seibel MJ, Lang M, Geilenkeuser WJ (2001) Interlaboratory variation of biochemical markers of bone turnover. Clin Chem 47:1443–1450
Faulkner KG, von Stetten E, Miller P (1999) Discordance in patient classification using T-scores. J Clin Densitom 2:343–350
Kanis JA, Adams J, Borgström F, Cooper C, Jönsson B, Preedy D, Selby P, Compston J (2008) The cost-effectiveness of alendronate in the management of osteoporosis. Bone 42:4–15
Kanis J (2009) International Osteoporosis Foundation, 8th European Union osteoporosis consultation panel meeting, Brussels, Belgium. http://www.iofbonehealth.org/download/osteofound/filemanager/policy_advocacy/EU-consultation-panel-meetings/8th-EU-consultation-panel-meeting071009.pdf, accessed 2 July 2010
Report of the International Osteoporosis Foundation 2008: osteoporosis in the European Union in 2008: 10 years of progress and ongoing challenges. http://www.sante.public.lu/publications/maladies-traitements/osteoporose/osteoporosis-eu-2008/osteoporosis-eu-2008.pdf, accessed 2 July 2010
Cramer JA, Amonkar MM, Hebborn A, Altman R (2005) Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 21:1453–1460
Seeman E, Compston J, Adachi J, Brandi ML, Cooper C, Dawson-Hughes B, Jönsson B, Pols H, Cramer JA (2007) Non-compliance: the Achilles’ heel of anti-fracture efficacy. Osteoporos Int 18:711–719
Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928
Ström O, Borgström F, Kanis JA, Jönsson B (2009) Incorporating adherence into health economic modelling of osteoporosis. Osteoporos Int 20:23–34
Canalis E, Giustina A, Bilezikian JP (2007) Mechanisms of anabolic therapies for osteoporosis. N Engl J Med 357:905–916
Rivadeneira F, Styrkársdottir U, Estrada K et al (2009) Twenty bone-mineral-density loci identified by large-scale meta-analysis of genome-wide association studies. Nat Genet 41:1199–1206
Little RD, Carulli JP, Del Mastro RG et al (2002) A mutation in the LDL receptor-related protein 5 gene results in the autosomal dominant high-bone-mass trait. Am J Hum Genet 70:11–19
Gong Y, Slee RB, Fukai N et al (2001) LDL receptor-related protein 5 (LRP5) affects bone accrual and eye development. Cell 107:513–523
Levasseur R, Lacombe D, de Vernejoul MC (2005) LRP5 mutations in osteoporosis-pseudoglioma syndrome and high-bone-mass disorders. Joint Bone Spine 72:207–214
van Meurs JB, Trikalinos TA, Ralston SH et al (2008) Large-scale analysis of association between LRP5 and LRP6 variants and osteoporosis. JAMA 299:1277–1290
Acknowledgement
The organisation of the 3rd Summit on Osteoporosis—CEE and the preparation of the manuscript were supported by an unrestricted educational grant of Amgen GmbH, Vienna, Austria.
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Members of the “3rd Summit on Osteoporosis—Central and Eastern Europe (CEE)”:
Silvano Adami, MD, PhD, Professor of Rheumatology, University of Verona, Verona, Italy, email: silvano.adami@univr.it
Carmen Barbu, MD, Assistant Professor of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, email: carmen_gabriela_barbu@yahoo.co.uk
Milan Bayer, MD, PhD, Professor of Paediatrics, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Czech Republic, email: bayerm@lfhk.cuni.cz
Janna Belaya, MD, PhD, senior research scientist, Department of Neuroendocrinology and Bone Diseases, National Research Center for Endocrinology, Moscow, Russia, e-mail: jannabelaya@gmail.com
Alexandar Dimic, MD, PhD, Professor of Rheumatology, Institute “Niska Banja”, Nis, Serbia, email: adimic@ptt.yu
Alexander Dreval, MD, PhD, Professor of Medicine, Moscow Regional Research Clinical Institute, Russian Federation, email: dreval@diabet.ru
Edward Franek, Prof. dr hab. n. med., Klinika Chorób Wewnętrznych, Endokrynologii i Diabetologii Centralny Szpital Kliniczny MSWiA Warszawa, Poland, and Department of Endocrinology, Medical Research Center of Polish Academy of Sciences, Warszawa, Poland, email: Edward.Franek@cskmswia.pl
Piotr Giuszko, MD, PhD, Associate Professor of Rheumatology, Jagiellonian University, Department of Rheumatology, Krakow, Poland, e-mail:zruj@mp.pl
Henrieta Halmová, MD, Endocrinology Out-patient Clinic, Distrinct Hospital, Lučenec, Slovakia
Laszlo Hodinka, MD, PhD, Department of Rheumatology, National Institute of Rheumatology and Phisiotherapy, Budapest, Hungary, email: hodinka.laszlo@orfi.hu
Wanda Horst-Sikorska, MD, PhD, Professor of Medicine, Department of Family Medicine Poznan University of Medical Sciences, Poznań, Poland, email: wanhorsi@umed.poznan.pl
Elżbieta Karczmarewicz, MD, PhD, Department of Biochemistry and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland, email: biochemia@czd.pl
Tomaz Kocjan, MD, PhD, Assist Professor of Medicine, Dept of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana., Ljubljana, SI-1525, Slovenia, email: tomaz.kocjan@kclj.si
Krystyna Księżopolska-Orłowska, MD, PhD, Department of Medical Rehabilitation, Rheumatology Institute, Warsaw, Poland, email: kko.post@home.pl
Stepan Kutilek, MD, PhD, Associate Professor of Paediatrics, Department of Paediatrics, Pardubice Hospital
Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic, e-mail: stepan.kutilek@nemocnice-pardubice.cz
Piotr Leszczyński, MD, PhD, CCD, Associate of Professor of Medicine, Department of Rheumatology and Osteoporosis, J. Strus Municipal Hospital, Medical University of Poznan, Poznan, Poland, email: piotr_leszczynski@wp.pl
Pavol Masaryk, MD, PhD, Osteocenter, National Institute of Rheumatic Diseases, Piestany, SK-921 01 Slovakia, e-mail: masaryk@nurch.sk
Waldemar Misiorowsky, MD, PhD, Senior Lecturer, Endocrinology Department, Medical Center for Postgraduate Education Bielanski Hospital, Warsaw, Poland, email: w_misior@cmkp.edu.pl
Olga Nachaeva, MD, Moscow Regional Research Clinical Institute, Russian Federation, email: olga1185@yandex.ru
Zsolt Nagy, MD, PhD, Assistant Professor of Medicine, 1st Department of Medicine, Semmelweis University Medical School, Hungary, email: zsolt@bel1.sote.hu
Pavel Novosad, MD, Head of Executive, MediekosLabor, Ltd., Czech Republic, email:novosad@avonet.cz
Vladislav Pvoroznyuk, MD, PhD, Professor of Medicine, Department of Clinical Physiology & Pathology of Locomotor Apparatus, Institute of Gerontology AMS of Ukraine, Director of Ukrainian Scientific-Medical Centre for the Problems of Osteoporosis, President of the Ukrainian Association of Osteoporosis, President of the Ukrainian Association of Andropause, Menopause, Bone and Joint Disease, Kyiv, 04108, Ukraine, email: roksolan@zeos.net
Jerzy Przedladzki, MD, Department of Nephrology, Dialysotherapy and Internal Diseases, Medical University of Warsaw, Warsaw, Poland and National Centre of Osteoporosis, Warsaw, Poland, email: jprzedlacki@amwaw.edu.pl
Janez Prezelj, MD, PhD, Professor of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia, email: janez.prezelj@kclj.si
Jan Rosa, MD, Department of Osteology/Rheumatology, DC MEDISCAN-Euromedic, Prague 11, Czech Republic, e-mail: rosaj@mediscan.cz
Peter Somogyi, MD, Assistant Professor of Orthopaedics, Department of Orthopedics, Semmelweis University Medical School, Hungary, email: sp@orto.sote.hu
Gabor Speer, MD, PhD, Assistant Professor of Medicine, 1st Department of Medicine, Semmelweis University Medical School, Hungary, email: speerga@bel1.sote.hu
Laszlo Szekeres, MD, Medical Director, Heviz, Hungary, email: szekereslaszlo@gmail.hu
Zsuzsanna Valkusz, MD, PhD, Head, Division of Endocrinology, Department of Medicine, Szentgyörgyi Albert University, Szeged, Hungary, valkusz@endoc.szote.u-szeged.hu
Vit Zikan, MD, PhD, 3rd Department of Internal Medicine, Charles University, Faculty of Medicine 1, Prague 2, Czech Republic, email: vitzikan@hotmail.com; email: vit.zikan@lf1.cuni.cz
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Lakatos, P., Balogh, Á., Czerwinski, E. et al. New considerations on the management of osteoporosis in Central and Eastern Europe (CEE): summary of the “3rd Summit on Osteoporosis—CEE”, November 2009, Budapest, Hungary. Arch Osteoporos 6, 1–12 (2011). https://doi.org/10.1007/s11657-010-0048-2
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DOI: https://doi.org/10.1007/s11657-010-0048-2