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A Review of Various Clinical Practice Guidelines on Osteoporosis in the Last 5 Years

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Abstract

Background

Osteoporosis, also called the silent disease, affects the elderly with a significant contribution to their morbidity and mortality through fragility fractures. Most nations have developed their own guidelines on managing this condition. Clinical Practice Guidelines (CPGs) are the highest quality evidence documents on a particular topic prepared by expert panels. CPGs offer standardised recommendations on a particular topic.

Methods

We looked at the CPGs of nations in the last five years and present the results of this review here. This review is divided into Risk assessment, prevention, diagnosis, Non pharmacological and pharmacological management with information from major CPGs only.

Results

Most CPGs agree on the broad principles of assessment , core risk factors, prevention and management with some finer differences in subtle aspects of assessment and management. There are differences in the use of screening tools based on the population numbers and affordability between nations. FRAX has been advocated for the screening with or without DEXA. Most CPGs use DEXA for confirmation of diagnosis. Intervention is based on FRAX scoring. Intervention thresholds vary. We discuss non-pharmacological management included diet and nutrition, calcium and Vitamin D, Exercise and physiotherapy, lifestyle changes and falls prevention. Pharmacological management included aspects of using different medications and their indications. The key agents recommended include Bisphosphonates, Teriparatide, Denosumab, SERMs, Hormone Replacement Therapy, and other agents including any drug holidays and duration of therapy.

Conclusions

This review identified some key recommendations from CPGs from multiple nations in each of the above given aspects of osteoporosis.

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Authors and Affiliations

  1. Lifesciences Engineering, Tata Consultancy Services, Mumbai, India

    Murali Poduval

  2. Sri Dhaatri, 23, Lane 2, SKDGOC, Vijayawada, Andhra Pradesh, 520008, India

    Srinivas B. S. Kambhampati

  3. Department of Orthopedics, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India

    Karthik Vishwanathan

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  1. Murali Poduval
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Correspondence to Murali Poduval.

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Poduval, M., Kambhampati, S.B.S. & Vishwanathan, K. A Review of Various Clinical Practice Guidelines on Osteoporosis in the Last 5 Years. JOIO 57 (Suppl 1), 7–24 (2023). https://doi.org/10.1007/s43465-023-01031-0

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