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[骨质疏松症——定义、风险评估、诊断、预防与治疗(2024年更新版):奥地利骨与矿物质研究学会指南]

[Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].

作者信息

Dimai Hans Peter, Muschitz Christian, Amrein Karin, Bauer Rosemarie, Cejka Daniel, Gasser Rudolf Wolfgang, Gruber Reinhard, Haschka Judith, Hasenöhrl Timothy, Kainberger Franz, Kerschan-Schindl Katharina, Kocijan Roland, König Jürgen, Kroißenbrunner Norbert, Kuchler Ulrike, Oberforcher Christine, Ott Johannes, Pfeiler Georg, Pietschmann Peter, Puchwein Paul, Schmidt-Ilsinger Alexander, Zwick Ralf Harun, Fahrleitner-Pammer Astrid

机构信息

Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich.

healthPi Medical Center, Medizinische Universität Wien, Wollzeile 1-3, 1010, Wien, Österreich.

出版信息

Wien Klin Wochenschr. 2024 Oct;136(Suppl 16):599-668. doi: 10.1007/s00508-024-02441-2. Epub 2024 Oct 2.

Abstract

BACKGROUND

Austria is among the countries with the highest incidence and prevalence of osteoporotic fractures worldwide. Guidelines for the prevention and management of osteoporosis were first published in 2010 under the auspices of the then Federation of Austrian Social Security Institutions and updated in 2017. The present comprehensively updated guidelines of the Austrian Society for Bone and Mineral Research are aimed at physicians of all specialties as well as decision makers and institutions in the Austrian healthcare system. The aim of these guidelines is to strengthen and improve the quality of medical care of patients with osteoporosis and osteoporotic fractures in Austria.

METHODS

These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1 June 2023 into consideration. The grading of recommendations used ("conditional" and "strong") are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV).

RESULTS

The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening.

CONCLUSION

The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system.

摘要

背景

奥地利是全球骨质疏松性骨折发病率和患病率最高的国家之一。骨质疏松症预防与管理指南于2010年在当时的奥地利社会保障机构联合会的主持下首次发布,并于2017年更新。奥地利骨与矿物质研究学会目前全面更新的指南面向所有专科医生以及奥地利医疗保健系统中的决策者和机构。这些指南的目的是加强和提高奥地利骨质疏松症和骨质疏松性骨折患者的医疗质量。

方法

这些基于证据的建议是在考虑随机对照试验、系统评价和荟萃分析以及2023年6月1日前发布的欧洲和国际参考指南的基础上编制而成的。所采用的推荐分级(“有条件”和“强烈”)基于证据的强度。证据水平采用了SIGN(1++至3)到NOGG标准(Ia至IV)的相互转换。

结果

该指南涵盖了与骨质疏松症和骨质疏松性骨折相关的所有方面,如继发原因、预防、诊断、使用FRAX®评估10年骨折风险、确定基于奥地利特定FRAX®的干预阈值、基于药物和非药物的治疗选择以及治疗监测。针对奥地利医疗保健系统中基于门诊的环境、决策者和机构的建议考虑了结构化护理模式和骨质疏松症特异性筛查的选项。

结论

该指南提供了关于骨质疏松症治疗的全面、基于证据的信息和指导。预计奥地利医疗保健系统各级针对这种临床情况患者的医疗质量将得到大幅提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80b4/11447007/ace5b0473b95/508_2024_2441_Fig1_HTML.jpg

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