Osteoporosis International最新文献

{"title":"Osteoporosis medication use over time in the United States and Canada.","authors":"Kaleen N Hayes, Andrew R Zullo, Sarah D Berry, Arman Oganisian, Sulbh Aggarwal, Michael Adegboye, Suzanne M Cadarette","doi":"10.1007/s00198-025-07484-3","DOIUrl":"10.1007/s00198-025-07484-3","url":null,"abstract":"<p><p>Over 12 years in the US and 26 years in Ontario, Canada, we found major differences in osteoporosis medications used. In both countries, osteoporosis medication initiation has not returned to pre-2008 levels; however, denosumab use is increasing. Future work should determine whether targeted screening or undertreatment drives these trends.</p><p><strong>Purpose: </strong>Concerns about adverse events caused a rapid decline in osteoporosis medication use globally between 2008 and 2012. Trends in use in recent years have not been described. We aimed to describe and compare trends over time in the initiation and overall use of osteoporosis medications among older adults in the US and Ontario, Canada.</p><p><strong>Methods: </strong>We conducted a serial cross-sectional study leveraging two data sources: healthcare administrative data for all older adult residents of Ontario, Canada (ON) and Medicare claims and enrollment data for a 20% random sample of beneficiaries (US). We included community-dwelling older adults aged ≥ 66 years at their first dispensing of an osteoporosis medication between 05/01/1996-12/31/2022 in ON and 01/01/2008-12/31/2020 in the US. We described and compared the number of incident and prevalent users of osteoporosis medications annually.</p><p><strong>Results: </strong>We identified 771,025 (average age = 75.2 years; 78% female) individuals in ON and 424,995 (average age = 75.3 years; 85% female) in the US initiating osteoporosis medications. In the US, alendronate and denosumab were the most common therapies, while in ON, risedronate and denosumab were most common. New use of osteoporosis medications dropped more between 2008 and 2011 in the US versus ON (58% vs. 29% relative decrease). Initiation of osteoporosis medications did not rebound to pre-2008 levels.</p><p><strong>Conclusion: </strong>New use of osteoporosis medications remains below pre-2008 levels, and differs between the US and Canada. Future research should aim to understand drivers of decreased use, like changes in the screening strategy used for initial treatment or persisting concerns about adverse effects.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1089-1094"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved radiological diagnosis of osteoporotic vertebral fragility fractures following UK-wide interventions and re-audit-can this be maintained and translated into clinical practice?","authors":"Hannah Adams, L Salman, K J Drinkwater, J Griffin, S Rowntree, D C Howlett","doi":"10.1007/s00198-025-07488-z","DOIUrl":"10.1007/s00198-025-07488-z","url":null,"abstract":"<p><p>To determine the potential economic, morbidity and mortality impact of improvements in reporting of vertebral fragility fractures (VFFs) following a complete audit cycle. Six percent interval increase in reporting of moderate/severe VFFs results in an additional 890 hip fractures predicted in year one and a potential cost saving of £13,207,000.</p><p><strong>Purpose: </strong>To determine the potential economic, morbidity and mortality impact of improvements in reporting of vertebral fragility fractures (VFFs) following an initial UK-wide audit initiated by the Royal College of Radiologists (RCR), collaborating with the Royal Osteoporosis Society (ROS) and Royal College of Physicians (RCP) and subsequent re-audit in 2022.</p><p><strong>Methods: </strong>Patient-specific and organisational questionnaires in 2019 and 2022 involved retrospective analysis of between 50 and 100 consecutive, non-traumatic CT studies which included the thoracolumbar spine where the spine was not the area of clinical interest in patients > 70 years. VFFs were recorded and the severity graded using the Genant reporting system. A series of UK-wide interventions were initiated between the audits. Results of the re-audit were evaluated using a bespoke ROS calculator to identify potential patient related and economic benefits from any improvements demonstrated.</p><p><strong>Results: </strong>Widespread improvements were evident between the two audits across all audit parameters, both patient-related and organisational. Notably, there was a 6% interval increase in reporting of moderate/severe VFFs (26 to 32%). Extrapolating from NHS England data, approximately 1.8 million non-trauma CT studies including the thoracolumbar spine for patients > 70 years were performed in the UK in 2022. The incidence of VFFs in the 2022 audit was found to be 21.7%. Using these figures and the 6% increase, the number of additional patients potentially diagnosed with a VFF equates to 23,420. Applying the ROS Benefits Calculator, in this cohort of 23,420 patients with no treatment, 890 hip fractures can be predicted in year one. With initiation of treatment, this figure falls to 328 patients (562 hip fractures prevented in year one), a potential cost saving of £13,207,000.</p><p><strong>Conclusion: </strong>The 2022 national re-audit confirmed improvements in radiology diagnostic performance and practice in VFF reporting. Ongoing work is required to build on this improvement and to further embed best practice. To realise this potential, there will need to be significant and maintained investment in onward referral and treatment systems (fracture liaison services or equivalent). Increasing availability of artificial intelligence will significantly increase the diagnoses of these fractures.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1069-1076"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with periprosthetic femoral fractures are older adults who are commonly diagnosed with osteoporosis.","authors":"Victoria Houel, Gauthier Marchasson, Nassima Ramdane, Cécile Philippoteaux, Julien Paccou","doi":"10.1007/s00198-025-07486-1","DOIUrl":"10.1007/s00198-025-07486-1","url":null,"abstract":"<p><p>This study focused on individuals aged ≥ 50 years with periprosthetic femoral fractures (PFF). When compared to those with native hip fractures, patients with PFF were older, had a higher BMI, and demonstrated a greater number of comorbidities. Given the high frequency of osteoporosis risk factors and the BMD results, PFF should be classified as osteoporotic fractures.</p><p><strong>Introduction: </strong>To compare patients presenting with periprosthetic femoral fractures (PFF) to patients with native hip fractures with a special focus on bone mineral density (BMD) measurements, in order to reinforce the hypothesis that PFF are osteoporotic fractures.</p><p><strong>Methods: </strong>A retrospective, single-centre, observational study of all patients aged ≥ 50 years with low-energy PFF identified at the Lille University Hospital from January 1, 2016, to December 31, 2022, was conducted. The PFF group was compared to a group of patients with native hip fractures hospitalized during the same period. To compare the T-score data, we used a linear mixed model that considered a predefined adjustment for age, sex, and BMI. Adjusted means ± standard error of the mean (SEM) are derived from the mixed model.</p><p><strong>Results: </strong>Among 71 patients with PFF (78.9% female, median (IQR) age 81 (72-88) years), osteoarthritis (57.8%) was the primary indication for hip surgery. Compared with the native hip fracture group (n = 117), patients in the PFF group were significantly older (p = 0.002), had a significantly greater BMI (p = 0.043), and had a higher history of multiple falls (54.3% vs. 26.1%, p < 0.001). A greater frequency of previous low-energy fractures (69.0% vs. 44.0%, p < 0.001) and an increased prescription of anti-osteoporosis medications (26.8% vs. 11.1%, p = 0.006) in patients with PFF were found. Adjusted T-scores differed between the two groups at the lumbar spine (mean adjusted ± SEM, - 0.5 ± 0.2 (PFF group) vs. - 1.2 ± 0.2 (comparator group), p = 0.008) but not at the femoral neck or at the total hip.</p><p><strong>Conclusion: </strong>Low-energy PFF should be considered as an osteoporotic fracture and treated accordingly.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1061-1068"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and incidence of osteoporotic vertebral fractures in community-dwelling European older adults: an observational analysis of the DO-HEALTH trial.","authors":"Andreas P Albrecht, Melanie Kistler-Fischbacher, Caroline De Godoi Rezende Costa Molino, Gabriele Armbrecht, Gregor Freystaetter, Robert Theiler, Reto W Kressig, Jose A P Da Silva, René Rizzoli, Guido A Wanner, Andreas Egli, Bess Dawson-Hughes, Heike A Bischoff-Ferrari","doi":"10.1007/s00198-025-07489-y","DOIUrl":"10.1007/s00198-025-07489-y","url":null,"abstract":"<p><p>We examined vertebral fracture (VF) prevalence, incidence, and treatment among 1488 older adults. VF prevalence and incidence were higher in women, older participants, and those with low bone density. In addition to VFs being underdiagnosed (only 20.7% of VFs clinically recognized), treatment rates were low, underscoring the need for improved screening and management.</p><p><strong>Purpose: </strong>To estimate prevalence and incidence of osteoporotic VFs and VF progressions overall and by sex, age, and bone status and to describe the proportion of participants with VFs in reporting osteoporosis (OP) medication use.</p><p><strong>Methods: </strong>This observational analysis of the DO-HEALTH trial, a three-year, randomized, controlled trial among community-dwelling adults age ≥ 70 years, includes a subsample of participants recruited at four study sites equipped with DXA machines. Prevalence and incidence rates (IR) of VFs and VF progressions were described overall and by subgroups of sex, age, and bone status. Incidence of VFs which were clinically recognized was also estimated. Further, we estimated the proportion of participants on OP medication.</p><p><strong>Results: </strong>A total of 1488 participants were included (mean age 74.9 years, 63.1% women, 77.0% had osteopenia or osteoporosis). One hundred forty-four (9.7%) participants had at least one radiographic VF at baseline and of those 19.4% participants reported OP medication use. Over the three-year follow-up, 50 participants sustained 58 new radiographic VFs (IR 1.4, 95% CI 1.1, 1.9). Of the 58 radiographic VFs, only 12 (20.7%) were clinically recognized. Furthermore, 31 participants sustained 35 VF progressions (N = 157; IR 7.7, 95% CI 5.5, 10.7). Prevalence and incidence were significantly higher in women, in older participants and those with osteopenia or osteoporosis compared to those with normal bone density.</p><p><strong>Conclusions: </strong>This study suggests a high prevalence and incidence of VFs in community-dwelling European older adults. Underdiagnosis may be even more prevalent than previously observed, and treatment rates were low.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1077-1088"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunistic assessment of osteoporosis using hip and pelvic X-rays with OsteoSight™: validation of an AI-based tool in a US population.","authors":"Robert J Pignolo, John J Connell, Will Briggs, Catherine J Kelly, Chris Tromans, Naima Sultana, J Michael Brady","doi":"10.1007/s00198-025-07487-0","DOIUrl":"10.1007/s00198-025-07487-0","url":null,"abstract":"<p><p>Identifying patients at risk of low bone mineral density (BMD) from X-rays presents an attractive approach to increase case finding. This paper showed the diagnostic accuracy, reproducibility, and robustness of a new technology: OsteoSight™. OsteoSight could increase diagnosis and preventive treatment rates for patients with low BMD.</p><p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic accuracy, reproducibility, and robustness of OsteoSight™, an automated image analysis tool designed to identify low bone mineral density (BMD) from routine hip and pelvic X-rays. Given the global rise in osteoporosis-related fractures and the limitations of current diagnostic paradigms, OsteoSight offers a scalable solution that integrates into existing clinical workflows.</p><p><strong>Methods: </strong>Performance of the technology was tested across three key areas: (1) diagnostic accuracy in identifying low BMD as compared to dual-energy X-ray absorptiometry (DXA), the clinical gold standard; (2) reproducibility, through analysis of two images from the same patient; and (3) robustness, by evaluating the tool's performance across different patient demographics and X-ray scanner hardware.</p><p><strong>Results: </strong>The diagnostic accuracy of OsteoSight for identifying patients at risk of low BMD was area under the receiver operating characteristic curve (AUROC) 0.834 [0.789-0.880], with consistent results across subgroups of clinical confounders and X-ray scanner hardware. Specificity 0.852 [0.783-0.930] and sensitivity 0.628 [0.538-0.743] met pre-specified acceptance criteria. The pre-processing pipeline successfully excluded unsuitable cases including incorrect body parts, metalwork, and unacceptable femur positioning.</p><p><strong>Conclusion: </strong>The results demonstrate that OsteoSight is accurate in identifying patients with low BMD. This suggests its utility as an opportunistic assessment tool, especially in settings where DXA accessibility is limited or not recently performed. The tool's reproducibility and robust performance across various clinical confounders further supports its integration into routine orthopedic and medical practices, potentially broadening the reach of osteoporosis assessment and enabling earlier intervention for at-risk patients.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1053-1060"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation, risk factors and management of pregnancy-associated osteoporosis: a systematic review and meta-analysis.","authors":"Elizabeth Orhadje, Navnit Makaram, Kathryn Berg, Barbara Hauser, Stuart H Ralston","doi":"10.1007/s00198-025-07479-0","DOIUrl":"10.1007/s00198-025-07479-0","url":null,"abstract":"<p><p>A systematic review and meta-analysis of the presentation, risk factors and treatment response of pregnancy-associated osteoporosis was conducted involving 35 studies and 943 patients. Vertebral fractures, back pain and family history of osteoporosis were common features. Analysis of treatment response was inconclusive due to limited availability of data.</p><p><strong>Introduction: </strong>Pregnancy-associated osteoporosis (PAO) is a rare disorder most often presenting with vertebral fractures during pregnancy or postpartum.</p><p><strong>Aims: </strong>This meta-analysis aimed to evaluate the presenting features of PAO, its risk factors and the effectiveness of various treatments at improving bone mineral density (BMD) and preventing further fractures.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE and Web of Science identified 35 studies comprising 943 cases of PAO. A meta-analysis was conducted to evaluate the effect of treatment on change in BMD at the lumbar spine, femoral neck and total hip.</p><p><strong>Results: </strong>Vertebral fractures and back pain occurred in 89.2% and 90.2% of cases, respectively. The diagnosis was predominantly made postpartum. The most common risk factor was a family history of osteoporosis (40.5%). Calcium and vitamin D supplements (31.8%) and teriparatide (30.8%) were the most commonly used treatments. The meta-analysis of BMD response was inconclusive due to limited availability of data. The BMD change at the lumbar spine was greater with teriparatide compared with calcium/vitamin D and bisphosphonates but this was based on only two studies. There was no difference in BMD response at the femoral neck. Recurrent fractures were reported in 12.9% with no difference between treatment groups.</p><p><strong>Conclusion: </strong>While this review can assist clinicians with the diagnosis and management of PAO, it highlights some key knowledge gaps that may inform conduct of a Delphi process on the diagnosis and management of this disorder, pending conduct of randomised controlled trials.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"981-993"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of calcifediol and cholecalciferol on muscle function in postmenopausal women: a randomized controlled trial.","authors":"Heike A Bischoff-Ferrari, Bess Dawson-Hughes, John E Orav, Lisa Ceglia, Andreas Egli, Melanie Kistler-Fischbacher, Maud Wieczorek, Caroline de Godoi Rezende Costa Molino","doi":"10.1007/s00198-025-07456-7","DOIUrl":"10.1007/s00198-025-07456-7","url":null,"abstract":"<p><p>Brief rationale: Limited evidence exists on calcifediol's effect on lower extremity function in postmenopausal women with osteoporosis or osteopenia.</p><p><strong>Main result: </strong>Calcifediol (20 µg/day) showed no greater benefit than vitamin D3 (3200 IU/day) or placebo. Significance of the paper: Findings do not support high-dose vitamin D3 or calcifediol for improving lower extremity function.</p><p><strong>Purpose: </strong>To test the effect of 20 µg/day of calcifediol compared with 3200 IU/day of vitamin D3 and placebo on lower extremity function in postmenopausal women with osteopenia or osteoporosis.</p><p><strong>Methods: </strong>This is a 3-arm double-blind RCT among postmenopausal women aged 50-70 years with serum 25(OH)D < 30 ng/mL, and a DXA-based diagnosis of osteopenia or osteoporosis. Participants were randomized to receive either daily 20 µg calcifediol, daily 3200 IU vitamin D3, or placebo. The primary endpoint was a composite measure of lower extremity function, assessed at baseline, 3, and 6 months, including four tests: gait speed, knee flexor and extensor strength, and repeated sit-to-stand test. The primary endpoint was the probability of success (improvement or maintenance from baseline) in any of the eight tests, four tests at 3 months and four tests at 6 months.</p><p><strong>Results: </strong>The trial enrolled 152 women (mean age, 61.0 years; mean serum 25(OH)D level, 23.4 ng/mL), and all but one woman completed all follow-up visits. Baseline characteristics, including the four tests of lower extremity function, were balanced across the three groups. The adjusted probability of success in any of the eight tests was 53.6% (95% confidence interval 47%, 60%) with calcifediol, 55.5% (50%, 61%) with vitamin D3, and 61.4% (55%, 67%) with placebo, without significant differences between treatment groups.</p><p><strong>Conclusions: </strong>Our findings do not support supplementation with daily calcifediol or equivalent high-dose daily vitamin D3 for improving or maintaining lower extremity function among younger postmenopausal women (age 50-70) with osteopenia or osteoporosis, who were pre-selected for vitamin D insufficiency or deficiency (25(OH)D < 30 ng/mL; baseline mean 25(OH)D 23.4 ng/mL).</p><p><strong>Trial registration: </strong>Clinicaltrials.gov; NCT02527668; https://clinicaltrials.gov/ct2/show/NCT02527668.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1007-1018"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision fracture risk assessment: leveraging genomic and clinical data for personalized care.","authors":"Qing Wu, Jongyun Jung","doi":"10.1007/s00198-025-07517-x","DOIUrl":"10.1007/s00198-025-07517-x","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"1099-1100"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lebanese GRADE-based vitamin D guidelines: a paradigm for the MENA region.","authors":"Marlene Chakhtoura, Elie Akl, Asma Arabi, Hala Ahmadieh, Stephanie Antoun, Paola Atallah, Rafic Baddoura, Maya Barake, Roger Bouillon, Peter Ebeling, Akram Echtay, Imad El-Kebbi, Marie Helene Ghannage-Yared, Georges Halaby, Nadine Hilal, Joanne Khabsa, Malek Nayfeh, Jad Okais, Mona Osman, Muheiddine Seoud, Imad Uthman, Ghada El-Hajj Fuleihan","doi":"10.1007/s00198-024-07375-z","DOIUrl":"10.1007/s00198-024-07375-z","url":null,"abstract":"<p><strong>Background: </strong>The Middle East and North Africa region are traditionally known as regions with a high prevalence of vitamin D deficiency. However, serum 25-hydroxyvitamin D (25OHD) levels seem to be increasing lately. We developed guidelines on the screening and supplementation of adult Lebanese patients with vitamin D. These guidelines address community-dwelling and institutionalized individuals.</p><p><strong>Methods: </strong>Our guideline panel consisted of clinical and methodology experts that formulated the guidelines questions. We conducted a systematic review to gather global data on fracture (CRD42019129540), regional data on vitamin D trials (CRD42014010488), and on patients' values and preferences (CRD42022320022). We also complemented the latter with results from a cross-sectional local study. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to assess the quality and certainty of evidence, and to develop recommendations.</p><p><strong>Results: </strong>For community-dwelling and institutionalized Lebanese adult population, the panel suggests no screening for vitamin D deficiency, over screening for vitamin D deficiency (conditional recommendation, based on very low certainty evidence). For community-dwelling Lebanese adult population, the panel suggests no supplementation with calcium and vitamin D, over supplementation (conditional recommendation, based on moderate certainty evidence). For institutionalized Lebanese adult population, the panel suggests supplementation with calcium and vitamin D, over no supplementation (conditional recommendation, based on moderate certainty evidence). The guidelines also identify high-risk subgroups, more likely to benefit from screening and supplementation. In community dwelling and institutionalized Lebanese adult individuals, for whom there is a decision to supplement with calcium and vitamin D, the panel suggests supplementation with a daily vitamin D equivalent of 600-2000 IU, as compared to doses higher than 2000 IU (conditional recommendation, very low certainty evidence).</p><p><strong>Conclusion: </strong>The Lebanese GRADE-based vitamin D guidelines recommend against population screening and vitamin D supplementation. Subgroups at high risk are identified. The guidelines take into account contextual factors, and allow their adoption or adaptation in countries in the region.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"937-950"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letters to the editor for\"Prognostic indicators in medication-related osteonecrosis of the jaw: a systematic review and meta-analysis\".","authors":"Akira Taguchi","doi":"10.1007/s00198-025-07531-z","DOIUrl":"https://doi.org/10.1007/s00198-025-07531-z","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}