[Diagnostics and treatment of osteoporosis in 2025 : An update on current guidelines].

Abstract

Osteoporosis is a relevant public health issue characterized by reduced bone mass and impaired bone microarchitecture, leading to an increased fracture risk. Osteoporosis is diagnosed based on low bone mineral density (BMD), specific fragility fractures and/or an elevated fracture risk. The BMD is one of the most important risk factors for the increased fracture risk that defines osteoporosis, alongside age and sex. Accordingly, treatment strategies focus on reducing the fracture risk. Risk gradients and an algorithm for fracture risk assessment guide treatment decisions. A primary osteoanabolic treatment is recommended for individuals with a 3-year fracture risk of 10% or higher and antiresorptive treatment where the risk exceeds 3%. The high disease burden and gaps in care highlight the need for targeted interventions. The introduction of new guidelines in Germany and Austria provides clear and individualized recommendations for action for the diagnosis and treatment of osteoporosis.