2024年英国骨质疏松症预防和治疗临床指南

IF 2.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Celia L. Gregson, David J. Armstrong, Christina Avgerinou, Jean Bowden, Cyrus Cooper, Lucy Douglas, John Edwards, Neil J. L. Gittoes, Nicholas C. Harvey, John A. Kanis, Sarah Leyland, Rebecca Low, Eugene McCloskey, Katie Moss, Jane Parker, Zoe Paskins, Kenneth Poole, David M. Reid, Mike Stone, Julia Tomson, Nic Vine, Juliet Compston, National Osteoporosis Guideline Group (NOGG)
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引用次数: 0

摘要

国家骨质疏松指南小组(NOGG)更新了经修订的英国指南,用于评估和管理绝经后女性和50岁及以上男性的骨质疏松症和预防脆性骨折。本指南适用于所有参与骨质疏松管理的医护人员。英国国家骨质疏松指南小组(NOGG)于2008年首次制定了骨质疏松症的预防和治疗指南,并于2013年、2017年和2021年进行了更新。本文对2021年指南进行了小幅更新,其范围是回顾50岁及以上绝经后女性和男性骨质疏松症的评估和管理以及脆弱性骨折的预防。方法在可用的情况下,系统综述、荟萃分析和随机对照试验被用于提供证据基础。结论和建议已根据现有证据的强度系统地进行了分级。结果综述了骨质疏松症的诊断、骨折风险评估和干预阈值、椎体骨折的管理、非药物和药物治疗(包括抗吸收治疗的持续时间和监测)、糖皮质激素性骨质疏松症以及骨折预防护理模式的证据和建议。为培训、服务主管和医疗保健专员以及审计和质量改进的审查标准提出建议。2024年的具体更新包括按种族、帕金森病、唐氏综合征和下肢截肢进行骨折风险评估的指南;此外,明确了极高骨折风险的定义。激素替代疗法(HRT)现在被推荐作为年轻的绝经后妇女的一线治疗选择,这些妇女骨折风险高,基线不良事件风险低;包括关于鲍巴肽的建议;增加了额外的培训资源。结论:该指南为所有参与骨质疏松症管理的医护人员提供了骨质疏松症评估和管理的全面概述。本立场文件已得到国际骨质疏松基金会和欧洲骨质疏松症、骨关节炎和肌肉骨骼疾病临床和经济方面学会(ESCEO)的认可。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The 2024 UK clinical guideline for the prevention and treatment of osteoporosis

Summary

The National Osteoporosis Guideline Group (NOGG) has updated the revised UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. This guideline is relevant for all healthcare professionals involved in osteoporosis management.

Introduction

The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013, 2017 and 2021. This paper presents a minor update of the 2021 guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men aged 50 years and older.

Methods

Where available, systematic reviews, meta-analyses and randomised controlled trials have been used to provide the evidence base. Conclusions and recommendations have been systematically graded according to the strength of the available evidence.

Results

Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, as well as models of care for fracture prevention. Recommendations are made for training, service leads and commissioners of healthcare, and for review criteria for audit and quality improvement. Specific 2024 updates include guidance on fracture risk assessment by ethnicity, Parkinson’s disease, Down’s syndrome and lower-limb amputation; furthermore, the definition of very high fracture risk has been clarified. Hormone replacement therapy (HRT) is now recommended as a first-line treatment option in younger postmenopausal women with high fracture risk and low baseline risk for adverse events; recommendations regarding abaloparatide are included; additional training resources have been added.

Conclusion

The guideline provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).

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来源期刊
Archives of Osteoporosis
Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS
CiteScore
5.50
自引率
10.00%
发文量
133
期刊介绍: Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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