open access
English
Guidelines for the diagnosis and management of osteoporosis in Poland. Update 2022
, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 11
Affiliations- Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
- Department of Endocrine Disorders and Bone Metabolism, Medical University of Lodz, Poland
- Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland
- Department of Paediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Poland
- Department of Geriatrics and Gerontology, School of Public Health, Medical Centre of Postgraduate Education, Warsaw, Poland
- Department of Orthopaedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
- Laboratory of Locomotor Systems Research, Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Poland
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Geriatrics Healthy Ageing Research Centre (HARC) Medical University of Lodz, Poland
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
- Multidisciplinary Osteoporosis Forum, Warsaw, Poland, Poland
- Department of Oncology Polish Mother’s Memorial Hospital — Research Institute, Lodz, Poland
- Committee for Rehabilitation, Physical Culture and Social Integration of the Polish Academy of Sciences, Krupia Wl., Poland
- Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia, Katowice, Poland
open access
Abstract
Guidelines to provide an update of the previously published Polish recommendations for the management of women and men with osteoporosis have been developed in line with advances in medical knowledge, evidence-based data, and new concepts in diagnostic and therapeutic strategies. A Working Group of experts from the Multidisciplinary Osteoporosis Forum and from the National Institute of Geriatrics, Rheumatology, and Rehabilitation in Warsaw performed a thorough comprehensive review of current relevant publications in the field (including all age groups of people and management of secondary osteoporosis), and they evaluated epidemiological data on osteoporosis in Poland and the existing standards of care and costs. A voting panel of all co-authors assessed and discussed the quality of evidence to formulate 29 specific recommendations and voted independently the strength of each recommendation.
This updated practice guidance highlights a new algorithm of the diagnostic and therapeutic procedures for individuals at high and very high fracture risk and presents a spectrum of general management and the use of medication including anabolic therapy. Furthermore, the paper discusses the strategy of primary and secondary fracture prevention, detection of fragility fractures in the population, and points to vital elements for improving management of osteoporosis in Poland.
Abstract
Guidelines to provide an update of the previously published Polish recommendations for the management of women and men with osteoporosis have been developed in line with advances in medical knowledge, evidence-based data, and new concepts in diagnostic and therapeutic strategies. A Working Group of experts from the Multidisciplinary Osteoporosis Forum and from the National Institute of Geriatrics, Rheumatology, and Rehabilitation in Warsaw performed a thorough comprehensive review of current relevant publications in the field (including all age groups of people and management of secondary osteoporosis), and they evaluated epidemiological data on osteoporosis in Poland and the existing standards of care and costs. A voting panel of all co-authors assessed and discussed the quality of evidence to formulate 29 specific recommendations and voted independently the strength of each recommendation.
This updated practice guidance highlights a new algorithm of the diagnostic and therapeutic procedures for individuals at high and very high fracture risk and presents a spectrum of general management and the use of medication including anabolic therapy. Furthermore, the paper discusses the strategy of primary and secondary fracture prevention, detection of fragility fractures in the population, and points to vital elements for improving management of osteoporosis in Poland.
Keywords
osteoporosis; diagnosis; fracture risk; treatment
About this articleTitle
Guidelines for the diagnosis and management of osteoporosis in Poland. Update 2022
Journal
Issue
Article type
Guidelines / Expert consensus
Pages
5-15
Published online
2023-02-22
Page views
6655
Article views/downloads
7328
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2023;74(1):5-15.
Keywords
osteoporosis
diagnosis
fracture risk
treatment
Authors
Piotr Głuszko
Ewa Sewerynek
Waldemar Misiorowski
Jerzy Konstantynowicz
Ewa Marcinowska-Suchowierska
Tomasz Blicharski
Mirosław Jabłoński
Edward Franek
Tomasz Kostka
Maciej Jaworski
Elżbieta Karczmarewicz
Ewa Kalinka
Krystyna Księżopolska-Orłowska
Andrzej Więcek
Roman S. Lorenc
References (19)- Lorenc R, Głuszko P, Franek E, et al. Guidelines for the diagnosis and management of osteoporosis in Poland : Update 2017. Endokrynol Pol. 2017; 68(5): 604–609.
- Głuszko P, Lorenc RS, Karczmarewicz E, et al. Working Group including the representatives of the Polish Associations of Orthopedics and Traumatology, Rehabilitation, Gerontology, Rheumatology, Family Medicine, Diabetology, Laboratory Diagnostics, Andropause and Menopause, Endocrinology, Radiology, and the STENKO group. Polish guidelines for the diagnosis and management of osteoporosis: a review of 2013 update. Pol Arch Med Wewn. 2014; 124(5): 255–263.
- Kanis JA, Harvey NC, McCloskey E, et al. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int. 2020; 31(1): 1–12.
- Camacho PM, Petak SM, Binkley N, et al. American Association of Clinical Endocrinologists/ American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis — 2020 Update. Endocr Pract. 2020; 26(5): 564–570.
- Ferrari S, Lippuner K, Lamy O, et al. 2020 recommendations for osteoporosis treatment according to fracture risk from the Swiss Association against Osteoporosis (SVGO). Swiss Med Wkly. 2020; 150: w20352.
- Eastell R, Vittinghoff E, Lui LY, et al. Validation of the Surrogate Threshold Effect for Change in Bone Mineral Density as a Surrogate Endpoint for Fracture Outcomes: The FNIH-ASBMR SABRE Project. J Bone Miner Res. 2022; 37(1): 29–35.
- Kanis JA, Cooper C, Rizzoli R, et al. Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2019; 30(1): 3–44.
- Adler RA, El-Hajj Fuleihan G, Bauer DC, et al. Managing Osteoporosis in Patients on Long-Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2016; 31(1): 16–35.
- Vandenput L, Johansson H, McCloskey EV, et al. Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan. Osteoporos Int. 2022; 33(10): 2103–2136.
- Galindo-Zavala R, Bou-Torrent R, Magallares-López B, et al. Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children. Pediatr Rheumatol Online J. 2020; 18(1): 20.
- Herath M, Cohen A, Ebeling PR, et al. Dilemmas in the Management of Osteoporosis in Younger Adults. JBMR Plus. 2022; 6(1): e10594.
- Willers C, Norton N, Harvey NC, et al. SCOPE review panel of the IOF. Osteoporosis in Europe: a compendium of country-specific reports. Arch Osteoporos. 2022; 17(1): 23.
- Narodowy Fundusz Zdrowia. NFZ o Zdrowiu: Osteoporoza. Centrala Narodowego Funduszu Zdrowia, Departament Analiz i Strategii, Warszawa 2019.
- Siris ES, Adler R, Bilezikian J, et al. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int. 2014; 25(5): 1439–1443.
- McLellan AR, Gallacher SJ, Fraser M, et al. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int. 2003; 14(12): 1028–1034.
- Black DM, Geiger EJ, Eastell R, et al. Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates. N Engl J Med. 2020; 383(8): 743–753.
- World Health Organisation. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994; 843: 1–129.
- Kanis JA, Johansson H, Harvey NC, et al. Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures. Osteoporos Int. 2020; 31(10): 1817–1828.
- Gregson CL, Armstrong DJ, Bowden J, et al. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. 2022; 17(1): 58.
