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Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

Journal article
Authors J. A. Kanis
N. C. Harvey
E. McCloskey
O. Bruyere
N. Veronese
Mattias Lorentzon
C. Cooper
R. Rizzoli
G. Adib
N. Al-Daghri
C. Campusano
M. Chandran
B. Dawson-Hughes
K. Javaid
F. Jiwa
H. Johansson
J. K. Lee
E. Liu
D. Messina
O. Mkinsi
D. Pinto
D. Prieto-Alhambra
K. Saag
W. Xia
L. Zakraoui
J. Y. Reginster
Published in Osteoporosis International
Volume 31
Pages 1–12
ISSN 0937-941X
Publication year 2020
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 1–12
Language en
Keywords Anabolic agents, Fracture risk assessment, FRAX, Inhibitors of bone, resorption, Treatment of osteoporosis, trabecular bone score, postmenopausal women, intervention thresholds, hip fracture, older-adults, prevention, exercise, time, bmd, teriparatide, Endocrinology & Metabolism
Subject categories Endocrinology


Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures. Introduction The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach. Methods Clinical perspective and updated literature search. Results The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis. Conclusions A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.

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