2012 update of French guidelines for the pharmacological treatment of postmenopausal osteoporosis

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• 作者：Karine Briot^a ; ^{karine.briot@cch.aphp.fr} ; Bernard Cortet^b ; Thierry Thomas^c ; Maurice Audran^d ; Hubert Blain^e ; Vé ; ronique Breuil^f ; Laure Chapuis^g ; Roland Chapurlat^h ; Patrice Fardelloneⁱ ; Jean-Marc Feron^j ; Jean-Bernard Gauvain^k ; Pascal Guggenbuhl^l ; ^m ; Sami Kolta^a ; Eric Lespessaillesⁿ ; Brigitte Letombe^o ; Christian Marcelli^p ; Philippe Orcel^q ; Patrick Seret^r ; Florence Tré ; molli&egrave ; res^s ; Christian Roux^a
• 关键词：Osteoporosis ; Menopause ; Fracture ; FRAX® ; not a MeSH term ; Absorptiometry ; Dual X-ray
• 刊名：Joint Bone Spine
• 出版年：2012
• 期刊代码：138_1297319x
• 类别：med
• 出版时间：May, 2012
• 卷：79
• 期：3
• 页码：304-313
• 文件大小：586 K

摘要

Objectives

To update the evidence-based position statement published by the French National Authority for Health (HAS) in 2006 regarding the pharmacological treatment of postmenopausal osteoporosis, under the auspices of the French Society for Rheumatology and Groupe de Recherche et d鈥橧nformation sur les Ost茅oporoses (GRIO), and with the participation of several learned societies (Coll猫ge National des Gyn茅cologues et Obst茅triciens Fran莽ais, Groupe d鈥櫭塼ude de la M茅nopause et du Vieillissement hormonal, Soci茅t茅 Fran莽aise de Chirurgie Orthop茅dique, Soci茅t茅 Fran莽aise d鈥橢ndocrinologie, and Soci茅t茅 Fran莽aise de G茅riatrie et de G茅rontologie).

Methods

A multidisciplinary panel representing the spectrum of clinical specialties involved in managing patients with postmenopausal osteoporosis developed updated recommendations based on a systematic literature review conducted according to the method advocated by the HAS.

Results

The updated recommendations underline the need for osteoporosis pharmacotherapy in women with a history of severe osteoporotic fracture. In these patients, any osteoporosis medication can be used; however, zoledronic acid is the preferred first-line medication after a hip fracture. In patients with non-severe fractures or no fractures, the appropriateness of osteoporosis pharmacotherapy depends on the bone mineral density and FRAX^庐 values; any osteoporosis medication can be used, but raloxifene and ibandronate should be reserved for patients at low risk for peripheral fractures. Initially, osteoporosis pharmacotherapy should be prescribed for 5 years. The results of the evaluation done at the end of the 5-year period determine whether further treatment is in order.

Conclusions

These updated recommendations are intended to provide clinicians with clarifications about the pharmacological treatment of osteoporosis.