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Evidence based Latin American Guidelines of clinical practice on prevention, diagnosis, management and treatment of glucocorticoid induced osteoporosis. A 2022 update

This manuscript has been produced under the auspices of the Committee of National Societies (CNS) and the Committee of Scientific Advisors (CSA) of the International Osteoporosis Foundation (IOF)

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Abstract

Guidelines and recommendations developed and endorsed by the International Osteoporosis Foundation (IOF) are intended to provide guidance for particular pattern of practice for physicians who usually prescribe glucocorticoid (GC) therapy, and not to dictate the care of a particular patient. Adherence to the recommendations within this guideline is voluntary and the ultimate determination regarding their application should be made by the physician in light of each patient’s circumstances. Guidelines and recommendations are intended to promote a desirable outcome but cannot guarantee any specific outcome. This guideline and its recommendations are not intended to dictate payment, reimbursement or insurance decisions. Guidelines and recommendations are subjected to periodic revisions as a consequence of the evolution of medicine, technology and clinical practice. A panel of Latin American (LATAM) experts specialized in osteoporosis with recognized clinical experience in managing patients with glucocorticoid-induced osteoporosis (GIO) met to produce evidence-based LATAM recommendations for the diagnosis and management of GIO. These guidelines are particularly intended to general practitioners and primary care physicians who prescribe GC treatments in LATAM to guide their daily clinical practice in terms of evaluation, prevention and treatment of GIO. These recommendations were based on systematic literature review using MEDLINE, EMBASE, SCOPUS and COCHRANE Library database during the period from 2012 to 2021. Randomized clinical trials (RCT), systematic reviews of RCT, controlled observational studies, guidelines and consensus were considered. Based on the review and expert opinion the panel members voted recommendations during two successive rounds of voting by panel members. Agreements for each statement were considered if a concordance of at least 70% was achieved following Delphi methodology. Grading of recommendations was made according to the Oxford Centre for the Evidence-based Medicine (EBM) criteria. Among five GIO guidelines and consensus initially identified, two of them (American College of Rheumatology 2017 and the Brazilian Guidelines 2021) were selected for comparison considering the latter as the most current guides in the LATAM region. Based on this methodology fifty statements were issued. All of them but four (1.20, 1.21, 1.23 and 4.2) attained agreement.

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Acknowledgements

This manuscript has been endorsed by the Committee of National Societies (CNS) and by the Committee of Scientific Advisors (CSA) of the International Osteoporosis Foundation (IOF)

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Author notes

  1. Rosa Maria Pereira: Deceased.

Authors and Affiliations

  1. Investigaciones Reumatológicas y Osteológicas (IRO). Collaborating Centre WHO, Buenos Aires, Argentina

    Osvaldo Daniel Messina, Constanza Arguissain & Andrea Cavallo

  2. International Osteoporosis Foundation (IOF), Latin America Region https://www.osteoporosis.foundation/

    Osvaldo Daniel Messina, Patricia Clark & Claudia Campusano

  3. Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru

    Maritza Vidal & Luis Fernando Vidal

  4. Hospital Aranda de La Parra. Leon, Guanajuato, Mexico

    Jorge A Morales Torres

  5. Chair of the Regional Advisory Council for Latin America – International Osteoporosis Foundation (IOF), Lima, Peru

    Luis Fernando Vidal

  6. Hospital das Clinicas, School of Medicine, University of São Paulo (HCFMUSP), São Paulo, Brazil

    Rosa María Pereira

  7. Regional Advisory Council Member-International Osteoporosis Foundation (IOF), Sao Paulo, Brazil

    Rosa María Pereira

  8. Hospital Federico Gomez School of Medicine UNAM, Mexico City, Mexico

    Patricia Clark & Lucia Mendez Sanchez

  9. Department of Endocrinology, Hospital CIMA, San José, Costa Rica

    Sonia Cerdas Perez

  10. Professor of Endocrinology, University of Costa Rica, San José, Costa Rica

    Sonia Cerdas Perez

  11. Universidad de Los Andes, Associate Professor, Santiago de Chile, Chile

    Claudia Campusano

  12. Escola Paulista de Medicina, São Paulo, Brazil

    Marise Lazaretti-Castro

  13. Centro Paulista de Investigação Clinica, São Paulo, Brazil

    Cristiano Zerbini

  14. Hospital C Durand, Buenos Aires, Argentina

    Juan J. Scali

  15. Sociedad Iberoamericana de Osteología y Metabolismo Mineral (SIBOMM)-President, Mexico City, Mexico

    Juan J. Scali

  16. Professor of Medicine UNAM, Mexico City, Mexico

    Maria L. Peralta-Pedrero

  17. IMSS, Mexico City, Mexico

    Francisco J. Valdivia Ibarra & Talina Hernandez Pérez

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  1. Osvaldo Daniel Messina
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Correspondence to Maritza Vidal.

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OD Messina received honoraria from Amgen, E Lilly and Pfizer. S Cerdas Perez received honoraria from Amgen, Novo Nordisk, MSD, AstraZeneca and Faes Farma. The other authors declare no conflict of interests.

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Messina, O.D., Vidal, M., Torres, J.A. et al. Evidence based Latin American Guidelines of clinical practice on prevention, diagnosis, management and treatment of glucocorticoid induced osteoporosis. A 2022 update. Aging Clin Exp Res 34, 2591–2602 (2022). https://doi.org/10.1007/s40520-022-02261-2

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