Abstract：
Guidelines and recommendations developed and endorsed by the International Osteoporosis Foundation (IOF) are intended to provide guidance for particular pattern of practice for physicians who usually prescribe glucocorticoid (GC) therapy, and not to dictate the care of a particular patient. Adherence to the recommendations within this guideline is voluntary and the ultimate determination regarding their application should be made by the physician in light of each patient\'s circumstances. Guidelines and recommendations are intended to promote a desirable outcome but cannot guarantee any specific outcome. This guideline and its recommendations are not intended to dictate payment, reimbursement or insurance decisions. Guidelines and recommendations are subjected to periodic revisions as a consequence of the evolution of medicine, technology and clinical practice. A panel of Latin American (LATAM) experts specialized in osteoporosis with recognized clinical experience in managing patients with glucocorticoid-induced osteoporosis (GIO) met to produce evidence-based LATAM recommendations for the diagnosis and management of GIO. These guidelines are particularly intended to general practitioners and primary care physicians who prescribe GC treatments in LATAM to guide their daily clinical practice in terms of evaluation, prevention and treatment of GIO. These recommendations were based on systematic literature review using MEDLINE, EMBASE, SCOPUS and COCHRANE Library database during the period from 2012 to 2021. Randomized clinical trials (RCT), systematic reviews of RCT, controlled observational studies, guidelines and consensus were considered. Based on the review and expert opinion the panel members voted recommendations during two successive rounds of voting by panel members. Agreements for each statement were considered if a concordance of at least 70% was achieved following Delphi methodology. Grading of recommendations was made according to the Oxford Centre for the Evidence-based Medicine (EBM) criteria. Among five GIO guidelines and consensus initially identified, two of them (American College of Rheumatology 2017 and the Brazilian Guidelines 2021) were selected for comparison considering the latter as the most current guides in the LATAM region. Based on this methodology fifty statements were issued. All of them but four (1.20, 1.21, 1.23 and 4.2) attained agreement.
摘要：
国际骨质疏松基金会（IOF）制定和认可的指南和建议旨在为通常开糖皮质激素（GC）治疗的医生提供特定的实践模式的指导。而不是规定特定病人的护理。遵守本指南中的建议是自愿的，医生应根据每个患者的情况对其应用做出最终决定。准则和建议旨在促进理想的结果，但不能保证任何具体结果。本准则及其建议并非旨在规定付款，报销或保险决定。由于医学的发展，准则和建议会受到定期修订，技术和临床实践。一个专门研究骨质疏松症的拉丁美洲（LATAM）专家小组在管理糖皮质激素诱导的骨质疏松症（GIO）患者方面具有公认的临床经验，旨在为GIO的诊断和管理提供基于证据的LATAM建议。这些指南特别适用于在LATAM开具GC治疗处方的全科医生和初级保健医生，以指导他们在评估方面的日常临床实践，GIO的预防和治疗。这些建议是基于使用MEDLINE的系统文献综述，EMBASE,2012年至2021年期间的SCOPUS和COCHRANE图书馆数据库。随机临床试验（RCT），RCT的系统评价，对照观察研究，考虑了指导方针和共识。根据审查和专家意见，小组成员在小组成员连续两轮投票中对建议进行了投票。如果按照Delphi方法至少达到70％的一致性，则考虑每个陈述的协议。根据牛津循证医学中心（EBM）标准对建议进行分级。在最初确定的五项GIO指南和共识中，选择其中两项(美国风湿病学会2017年和巴西指南2021年)进行比较,认为后者是LATAM地区最新指南.根据这一方法，发表了50份声明。除四个（1.20、1.21、1.23和4.2）外，所有人都达成了协议。
