2018 update of French recommendations on the management of postmenopausal osteoporosis.

Abstract

OBJECTIVES:

To update the 2012 recommendations on pharmacotherapy for postmenopausal osteoporosis, under the aegis of the Bone Task Force of the French Society for Rheumatology (SFR) and of the Osteoporosis Research and Information Group (GRIO), in collaboration with scientific societies (Collège national des généralistes enseignants, Collège national des gynécologues et obstétriciens français, Fédération nationale des collèges de gynécologie médicale, Groupe d'étude de la ménopause et du vieillissement hormonal, Société française de chirurgie orthopédique, Société française d'endocrinologie, and Société française de gériatrie et de gérontologie).

METHODS:

Updated recommendations were developed by a task force whose members represented the medical specialties involved in the management of postmenopausal osteoporosis. The update was based on a literature review and developed using the method advocated by the French National Authority for Health (HAS).

DISCUSSION AND CONCLUSION:

The updated recommendations place strong emphasis on the treatment of women with severe fractures, in whom the use of osteoporosis medications is recommended. All the available osteoporosis medications are suitable in patients with severe fractures; zoledronic acid deserves preference as the fist-line drug after a hip fracture. In patients with or without non-severe fractures, the decision to use osteoporosis medications is based on bone mineral density values and in challenging cases, on probabilities supplied by prediction tools such as FRAX®. All osteoporosis medications are suitable; raloxifene should be reserved for patients at low risk for peripheral fractures. The fracture risk should be reevaluated every 2 to 3 years to decide on the best follow-up treatment. These updated recommendations discuss the selection of first-line osteoporosis medications and treatment sequences.

• Authors: Karine Briot, Christian Roux, Thierry Thomas, Hubert Blain, Daniel Buchon, Roland Chapurlat, Françoise Debiais, Jean Marc Feron, Jean Bernard Gauvain, Pascal Guggenbuhl, Eric Legrand, Anne Marie Lehr-Drylewicz, Eric Lespessailles, Florence Tremollieres, Georges Weryha, Bernard Cortet
• Journal: Joint bone spine (Joint Bone Spine) Vol. 85 Issue 5 Pg. 519-530 (10 2018) ISSN: 1778-7254 [Electronic] France
• PMID: 29654947 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018. Published by Elsevier Masson SAS.

Chemical References

• Bone Density Conservation Agents
• Diphosphonates

Topics

• Absorptiometry, Photon (methods)
• Aged
• Bone Density
• Bone Density Conservation Agents (therapeutic use)
• Diphosphonates (therapeutic use)
• Disease Management
• Female
• Forecasting
• France
• Humans
• Middle Aged
• Osteoporosis, Postmenopausal (diagnosis, drug therapy, epidemiology)
• Osteoporotic Fractures (prevention & control)
• Practice Guidelines as Topic
• Prognosis
• Risk Assessment