目的:为比利时绝经后妇女骨质疏松症的管理提供最新的循证指南。
方法:比利时骨俱乐部(BBC)聚集了一个指南开发小组。九“人口,干预,比较器,结果\“(PICO)问题涵盖筛选,诊断,非药物和药物治疗,并制定了监控措施。系统搜索MEDLINE,Cochrane系统评价数据库,Scopus被用来寻找网络荟萃分析,荟萃分析,系统评价,指导方针,以及过去10年发表的科学学会的建议。还进行了手动搜索。提供了证据摘要,BBC董事会成员和其他国家科学协会的专家进一步验证了这些建议。
结果:在搜索的3840个参考文献中,对333篇全文进行了资格评估,129符合纳入标准。应考虑使用临床危险因素进行骨质疏松筛查。最近(<2年)严重骨质疏松性骨折的患者被认为具有非常高且迫在眉睫的未来骨折风险。通过双能X射线吸收法测量的骨矿物质密度和10年骨折风险的组合用于将患者分类为低风险或高风险。患者教育,负重和阻力训练的结合,建议最佳钙摄入量和维生素D状态。对于高和非常高的骨折风险患者,应考虑抗吸收和合成代谢骨质疏松症治疗。分别。后续行动应侧重于遵守,应考虑为患者量身定制的监测。
结论:BBC指南和25个指南建议弥合了筛查研究与临床实践之间的差距,诊断,和骨质疏松症的管理。
OBJECTIVE: To provide updated evidence-based
guidelines for the management of osteoporosis in postmenopausal women in Belgium.
METHODS: The Belgian Bone Club (BBC) gathered a
guideline developer group. Nine \"Population, Intervention, Comparator, Outcome\" (PICO) questions covering screening, diagnosis, non-pharmacological and pharmacological treatments, and monitoring were formulated. A systematic search of MEDLINE, the Cochrane Database of Systematic Reviews, and Scopus was performed to find network meta-analyses, meta-analyses, systematic reviews,
guidelines, and recommendations from scientific societies published in the last 10 years. Manual searches were also performed. Summaries of evidence were provided, and recommendations were further validated by the BBC board members and other national scientific societies\' experts.
RESULTS: Of the 3840 references in the search, 333 full texts were assessed for eligibility, and 129 met the inclusion criteria. Osteoporosis screening using clinical risk factors should be considered. Patients with a recent (<2 years) major osteoporotic fracture were considered at very high and imminent risk of future fracture. The combination of bone mineral density measured by dual-energy X-ray absorptiometry and 10-year fracture risk was used to categorize patients as low or high risk. Patient education, the combination of weight-bearing and resistance training, and optimal calcium intake and vitamin D status were recommended. Antiresorptive and anabolic osteoporosis treatment should be considered for patients at high and very high fracture risk, respectively. Follow-up should focus on compliance, and patient-tailored monitoring should be considered.
CONCLUSIONS: BBC
guidelines and 25
guideline recommendations bridge the gap between research and clinical practice for the screening, diagnosis, and management of osteoporosis.