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The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults

  • Position Paper
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

The Indian Society for Bone and Mineral Research (ISBMR) has herein drafted clinical practice guidelines for the diagnosis and management of osteoporosis for the people of India. Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

Purpose

In India, osteoporosis is a major public health problem. However, in the absence of any robust regional guidelines, the screening, treatment, and follow-up of patients with osteoporosis are lagging behind in the country.

Methods

The Indian Society for Bone and Mineral Research (ISBMR), which is a multidisciplinary group of physicians, researchers, dietitians, and epidemiologists and who study bone and related tissues, in their annual meeting, drafted the guidelines for the diagnosis and management of osteoporosis that would be appropriate in a resource constraint setting like India.

Results

Diagnosis of osteoporosis can be made in a patient with minimal trauma fracture without the aid of any other diagnostic tools. In others, bone mineral density measured by dual-energy X-ray absorptiometry remains the modality of choice. Data indicates that osteoporotic fractures occur at an earlier age in Indians than in the West; hence, screening for osteoporosis should begin at an earlier age. FRAX can be used for fracture risk estimation; however, it may underestimate the risk of future fractures in our population and still needs validation. Maintaining optimum serum 25-hydroxyvitamin D levels is essential, which, in most cases, would require regular vitamin D supplementation. Pharmacotherapy should be guided by the presence/absence of vertebral/hip fractures or the severity of risk based on clinical factors, although bisphosphonates remain the first choice in most cases. Regular follow-up is essential to ensure adherence and response to therapy.

Conclusions

Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

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Authors and Affiliations

  1. Department of Endocrinology, Post Graduate Institute Of Medical Education and Research, Chandigarh, 160012, India

    Sanjay K. Bhadada, Rimesh Pal & Soham Mukherjee

  2. Department of Endocrinology, Parmanand Deepchand Hinduja Hospital, Mumbai, 400016, India

    Manoj Chadha

  3. Endocrinology and Diabetology Division, Voluntary Health Services Hospital, Chennai, 600020, India

    Usha Sriram

  4. Department of Endocrinology, Christian Medical College, Vellore, 632002, India

    Thomas V. Paul & Nitin Kapoor

  5. Department of Endocrinology, All India Institute Of Medical Sciences, New Delhi, 110023, India

    Rajesh Khadgawat & Nikhil Tandon

  6. Endocrinology Division, Bhaktivedanta Hospital, Thane, 401107, India

    Ameya Joshi

  7. Endocrinology and Diabetes Division, Door to Care, Gurgaon, 122018, India

    Beena Bansal

  8. Department of Endocrinology, Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India

    Anshita Aggarwal

  9. Department of Endocrinology, All India Institute Of Medical Sciences, Jodhpur, 342001, India

    Mahendra K. Garg

  10. Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Sushil Gupta

  11. Department of Endocrinology, Army Hospital Research & Referral, New Delhi, 110010, India

    Narendra Kotwal

  12. Endocrinology Division, Sri Ramachandra Medical Center, Chennai, 600116, India

    Shriraam Mahadevan

  13. Department of Endocrinology, Institute of Post-Graduate Medical Education and Research, Kolkata, 700020, India

    Satinath Mukhopadhyay

  14. Department of Medicine, University of Illinois, Chicago, IL, 60612, USA

    Subhash C. Kukreja

  15. Department of Internal Medicine, Division of Endocrinology, Diabetes and Bone & Mineral Disorders, Henry Ford, Health System, Detroit, MI, 48202, USA

    Sudhaker D. Rao

  16. Endocrinology and Diabetes Division, Max Healthcare, New Delhi, 110017, India

    Ambrish Mithal

Authors
  1. Sanjay K. Bhadada
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  2. Manoj Chadha
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  3. Usha Sriram
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  4. Rimesh Pal
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  5. Thomas V. Paul
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  6. Rajesh Khadgawat
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  7. Ameya Joshi
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  8. Beena Bansal
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  9. Nitin Kapoor
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  10. Anshita Aggarwal
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  11. Mahendra K. Garg
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  12. Nikhil Tandon
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  13. Sushil Gupta
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  14. Narendra Kotwal
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  15. Shriraam Mahadevan
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  16. Satinath Mukhopadhyay
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  17. Soham Mukherjee
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  18. Subhash C. Kukreja
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  19. Sudhaker D. Rao
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  20. Ambrish Mithal
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Contributions

All authors contributed to the study conception and design. The initial version of the manuscript was drafted by Sanjay K. Bhadada, Manoj Chadha, Usha Sriram, Rimesh Pal, Thomas Paul, Nitin Kapoor, Ameya Joshi, Beena Bansal, Sushil Gupta, and Ambrish Mithal. The initial draft was edited and revised by Sanjay K. Bhadada, Ambrish Mithal, Satinath Mukhopadhay, Soham Mukherjee, Mahendra K. Garg, Narendra Kotwal, Nikhil Tandon, Rajesh Khadgawat, Subhash C. Kukreja, and Sudhaker D. Rao. All authors read and approved the final version of the manuscript.

Corresponding authors

Correspondence to Sanjay K. Bhadada or Ambrish Mithal.

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Being a position statement, ethical committee approval was not required.

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Not applicable.

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Bhadada, S.K., Chadha, M., Sriram, U. et al. The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults. Arch Osteoporos 16, 102 (2021). https://doi.org/10.1007/s11657-021-00954-1

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