Federal clinical guidelines for diagnosis, treatment and prevention of osteoporosis-Reference-Cited by-同舟云学术

Federal clinical guidelines for diagnosis, treatment and prevention of osteoporosis

Published:2021-11-10 Issue:2 Volume:24 Page:4-47
ISSN:2311-0716
Container-title:Osteoporosis and Bone Diseases
language:
Short-container-title:Osteopor Bone Dis

Author:

Belaya Zh. E.¹^ORCID,Belova K. Yu.²^ORCID,Biryukova E. V.³^ORCID,Dedov I. I.¹^ORCID,Dzeranova L. K.¹^ORCID,Drapkina O. M.⁴^ORCID,Dreval A. V.⁵^ORCID,Dubovitskaya T. A.¹^ORCID,Dudinskaya E. N.⁶^ORCID,Ershova O. B.⁷^ORCID,Zagorodniy N. V.⁸^ORCID,Ilyukhina O. B.⁹^ORCID,Kanis J. A.¹⁰^ORCID,Kryukova I. V.⁵^ORCID,Lesnyak O. M.¹¹^ORCID,Mamedova E. O.¹^ORCID,Marchenkova L. A.¹²^ORCID,Mel’nichenko G. A.¹^ORCID,Nikankina L. V.¹^ORCID,Nikitinskaya O. A.¹³^ORCID,Petryaikin A. V.¹⁴^ORCID,Pigarova E. A.¹^ORCID,Rodionova S. S.⁸^ORCID,Rozhinskaya L. Ya.¹^ORCID,Skripnikova I. A.⁴^ORCID,Tarbaeva N. V.¹^ORCID,Tkacheva O. N.⁶^ORCID,Toroptsova N. V.¹³^ORCID,Farba L. Ya.¹⁵^ORCID,Tsoriev T. T.¹^ORCID,Chernova T. O.¹^ORCID,Yureneva S. V.¹⁶^ORCID,Yakushevskaya O. V.¹⁶^ORCID

Affiliation:

1. Endocrinology Research Centre

2. Clinical Ambulance Hospital named after N.V. Solovyov; Yaroslavl’ State Medical University

3. Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

4. National Research Center for Preventive Medicine

5. Moscow Regional Research Clinical Institute named after M.F. Vladimirskiy

6. Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation – Russian Gerontological Research and Clinical Center

7. Yaroslavl’ State Medical University

8. Central Research Institute of Traumatology and Orthopedics named after N.N. Priorov

9. Orenburg Regional Clinical Hospital №2

10. The University of Sheffield (Centre for Metabolic Bone Diseases)

11. North-Western State Medical University named after I.I. Mechnikov

12. National Medical Research Center of Rehabilitation and Balneology

13. Research Institute of Rheumatology named after V.A. Nasonova

14. Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

15. City Clinical Hospital №13

16. Research Center for Obstetrics, Gynecology and Perinatology

Abstract

Due to continuous aging of population and increase in the number of elderly people, osteoporosis became socially significant disease leading to disability, increasing mortality and thereby putting an additional burden on the public healthcare system.Screening to identify groups with a high probability of fracture is recommended using the FRAX® Tool for all postmenopausal women and men over 50 years old (А1). In the presense of major pathological fractures (hip, spine, multiple fractures) it is recommended to diagnose osteoporosis and prescribe treatment regardless of the results of spine and hip double X-ray absorptiometry (DXA) or FRAX® (B2).It is recommended to evaluate C-terminal telopeptide when prescribing antiresorptive therapy and procollagen type 1 N-terminal propeptide (P1NP) when prescribing anabolic therapy to patients receiving osteoporosis treatment at baseline and 3 months after the start of therapy in order to assess the effectiveness of treatment early and adherence to the therapy (А2). It is recommended to diagnose osteoporosis and prescribe treatment to patients with high individual 10-year probability of major pathological fractures (FRAX®) regardless of the results of spine and hip DXA (В3).It is recommended to diagnose osteoporosis and prescribe treatment with a decrease in BMD, measured by DXA, by 2.5 or more T-score standard deviations in femoral neck, and/or in total hip, and/or in lumbar vertebrae, in postmenopausal women and men over 50 years old (А2).It is recommended to prescribe bisphosphonates, denosumab or teriparatide to prevent pathological fractures and increase BMD in patients with postmenopausal osteoporosis, osteoporosis in men, glucocorticoid-induced osteoporosis (А2). When the clinical effect of therapy in osteoporotic patients without pathological fractures is achieved (BMD T-score > -2.0 SD in femoral neck and absence of new fractures), it is recommended to interrupt bisphosphonates therapy for 1-2 years with subsequent follow-up (B2). In patients with vertebral fractures, hip fractures or multiple fractures, it is recommended to continue ceaseless long-term treatment of osteoporosis (В3).All drugs for the treatment of osteoporosis are recommended to be prescribed in combination with calcium and cholecalciferol (А2). In order to reduce the risk of recurrent fractures by prescribing osteoporosis therapy timely and maintaining long-term follow-up of patients over 50 years old with pathological fractures, it is recommended to create Fracture Liaison Services (В2).

Publisher

Endocrinology Research Centre

Subject

Automotive Engineering

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