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波兰骨质疏松症诊断和管理指南。2022 年更新。

Guidelines for the diagnosis and management of osteoporosis in Poland. Update 2022.

机构信息

Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland.

Department of Endocrine Disorders and Bone Metabolism, Medical University of Lodz, Poland.

出版信息

Endokrynol Pol. 2023;74(1):5-15. doi: 10.5603/EP.a2023.0012.

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.

摘要

为了与医学知识的进步、循证数据以及诊断和治疗策略的新概念保持一致,制定了更新先前发表的波兰骨质疏松症管理建议的指南。来自华沙多学科骨质疏松症论坛和国家老年病学、风湿病学和康复研究所的专家工作组对该领域的当前相关出版物(包括所有年龄段人群和继发性骨质疏松症的管理)进行了全面彻底的审查,并评估了波兰骨质疏松症的流行病学数据以及现有的护理标准和成本。所有合著者的投票小组评估并讨论了证据质量,以制定 29 条具体建议,并对每条建议的强度进行独立投票。本更新的实践指南突出了高和极高骨折风险个体的诊断和治疗程序的新算法,并介绍了一般管理和药物使用的范围,包括合成代谢治疗。此外,本文还讨论了一级和二级骨折预防策略、人群中脆性骨折的检测,并指出了改善波兰骨质疏松症管理的重要因素。

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