The 2018 Guidelines for the diagnosis and treatment of osteoporosis in Greece

Makras, Polyzois; Anastasilakis, Athanasios D.; Antypas, G; Chronopoulos, Efstathios; Kaskani, Evangelia; Matsouka, Aikaterini; Patrikos, D; Stathopoulos, Konstantinos; Tournis, Symeon; Trovas, George; Kosmidis, Christos

doi:10.1007/s11657-019-0584-3

Cited by 37 publications

(30 citation statements)

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“…Nine out of the 33 guidelines didn’t assign grades for level of evidence or strength of recommendation to their recommendations. These were the Canadian Task Force 2004 [43], Lebanese CPG 2005 [51], Guidelines in Asia 2006 [42], NOF 2008 [47], Update of the Lebanese CPG 2008 [53], Greece 2011 [57], British Columbia CPG 2012 [44], NOF 2014 [48], Alberta CPG 2016 [70]. Seven guidelines used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system [20], which many organizations are adopting or modifying for their use.…”

Section: Resultsmentioning

confidence: 99%

“…BMD testing before FRAX:Only four CPGs (Osteoporosis Canada 2010 [40], Australia 2010[38], National osteoporosis society of South Africa 2010[56], and Greece 2011[57]) recommend BMD testing before FRAX risk estimation especially for those <65 years of age. However, the recommendation for using FRAX is governed by the availability of country specific data and in countries like India where such data is not available, FRAX can’t recommended to be use neither before, nor after BMD testing.…”

Section: Resultsmentioning

confidence: 99%

“…A 10-year risk of major osteoporotic fracture of ≥ 20% is the intervention threshold in most guidelines (Osteoporosis Canada 2010 [40], Taiwan 2011 [60], British Columbia 2012 [44], SOGC 2014 [64], and Alberta 2016 [70]). The third approach is using the T-score threshold, and if it is at the osteopenia level (T-score between -1 to -2.5), then FRAX score threshold is applied to decide treatment CPGs that used this approach are: Greece CPG2011 [57], Endocrine Society 2012 [62], Institute for clinical system improvement guideline 2013 [45], NOF 2014 [48], The Malaysian osteoporosis society 2015 [66], and the Italian Society 2016 [69].…”

Section: Resultsmentioning

confidence: 99%

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Screening for osteoporosis: A systematic assessment of the quality and content of clinical practice guidelines, using the AGREE II instrument and the IOM Standards for Trustworthy Guidelines

et al. 2018

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BackgroundNumerous clinical practice guidelines (CPGs) are published to guide management of osteoporosis. Little is known about their quality or how recommendations have changed over time.ObjectiveTo systematically assess the quality and content of the guidelines on screening for osteoporosis, using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool, and the Institute of Medicine (IOM) standards for trustworthy guidelines.MethodsWe conducted a systematic search for osteoporosis CPGs published between 2002–2016, using multiple databases and guideline websites. Two reviewers appraised the quality of eligible CPGs using the AGREE II. High quality CPGs were considered if they scored ≥ 60 in four or more domains including the domain for rigor of development. Non-parametric tests were used to test for the change of quality over time. One reviewer assessed the guidelines with IOM standards. We summarized the different evidence grading systems and extracted and compared the recommendations.ResultsA total of 33 CPGs were identified. The mean scores for AGREE II differed by domain (range: 42% to 71%). CPGs scored higher on domains for clarity of presentation, scope and purpose, and rigor of development. CPGs scored lower on domains for stakeholder involvement, editorial independence and applicability. Assessment of CPGs by IOM standards showed that CPGs scored better on standards for systematic review, establishing evidence foundation and rating strength of recommendation, articulation of recommendation, and establishing transparency. While scored lower on standards for updating, external review, and the development group composition. There was no difference in AGREE II and IOM defined guidelines’ quality before and after the introduction of the two tools (P values >0.05). The IOM identified four more guidelines as high quality compared to the AGREE II. Examining these additional guidelines indicated that the two tools may give conflicting results especially for the rigor of development domain. Recommendations in certain areas showed substantial differences between guidelines.ConclusionOsteoporosis screening CPGs are of variable quality, and their recommendations often differ. Guideline quality as measured by AGREE II and IOM standards has not improved overtime. Guideline developers should work together to improve the quality and consistency of recommendations to improve the likelihood that their guidelines will be used in practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Screening for osteoporosis: A systematic assessment of the quality and content of clinical practice guidelines, using the AGREE II instrument and the IOM Standards for Trustworthy Guidelines

et al. 2018

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“…The recommended diagnostic criterion for OP was reduction of dual-energy X-ray bone density equal or higher than 2.5 standard difference [15].…”

Section: Inclusion Criteriamentioning

confidence: 99%

Effect of vitamin K2 on bone mineral density and serum cathepsin K in female osteoporosis patients

Gu¹,

Runlin²,

Xu³

et al. 2019

Trop. J. Pharm Res

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Purpose: To investigate the influence of vitamin K2 on bone mineral density, bone metabolism and serum tissue protease K (cathepsin K) in female patients with osteoporosis. Method: A total of 210 osteoporosis patients in Affiliated Hospital of Nanjing University of Chinese Medicine who met the inclusion criteria were selected from January 2017 to January 2018. The patients were randomly divided into vitamin K2 group, strontium renate group and blank control group (70 patients/group). Strontium ranelate group was orally given 2 g of strontium ranelate daily, while vitamin K2 group received 15 mg of Gulikang capsule 3 times a day. Bone mineral density (BMD) and serum osteocalcin (BGP), β-collagen degradation product (β-crosslaps), type I procollagen amino terminal propeptide (PINP), cathepsin K (cathe K) and TRAP were measured prior to drug treatment, and six months after surgery, using standard procedures. Results: Relative to the blank control, hip and lumbar spine density of vitamin K2 and strontium ranelate groups increased to varying degrees. Strontium ranelate group had significantly higher bone mineral density (BMD) than any other groups (p < 0.05), and also had the lowest osteoclast activity (β-crosslaps and TRAP) and the highest osteogenic activity (BGP and PINP). On the other hand, osteoclast and osteogenic activities increased significantly (p < 0.05) in the vitamin K2 group. Conclusion: Appropriate vitamin K2 treatment improves BMD in the hip and waist of women with osteoporosis by promoting osteogenic activity, and by reducing osteoclast activity and cathepsin K expression.

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“… Edad entre 50 -64 años con : -Fractura de fragilidad después de los 40 años.-Fractura vertebral o osteopenia detectada en radiografía.-Padres con factura de cadera.-Bajo peso (< 60 kg) o importante pérdida de peso (> 10% del peso a los 25 años).-Tabaquismo activo.-Ingesta de alcohol (mayor de 25 -30 g/día).-Enfermedades y medicamentos que están estrechamente relacionados con la osteoporosis, pérdida rápida de masa ósea o fracturas. Edad menor de 50 años con:-Fractura de fragilidad.-Hipogonadismo o menopausia prematura (menores de 45 años).-Hiperparatiroidismo primario.-Síndromes malabsortivos.-Enfermedades y medicamentos que están estrechamente relacionados con la osteoporosis, pérdida rápida de masa ósea o fracturas.Se recomienda tratar cuando se cumple unos de los siguientes criterios357 : Fractura vertebral o de cadera. Más de una fractura de fragilidad en otras localizaciones. T-score ≤ -2,5 DE. Para individuos en el rango de osteopenia dependerá del riesgo de fractura calculado mediante la versión griega de la herramienta FRAX ® :-Riesgo de fractura principal mayor de 20% o de fractura de cadera mayor de 3%.-Riesgo de fractura principal entre 10 y 20 % si se asocia con: o Fractura de muñeca después de los 65 años. o Descenso significativo (>5%) de la DMO entre dos mediciones.…”

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Implicaciones de la utilización de las guías de mayor impacto internacional (NOGG y NOF) como de otras guías (internacionales, nacionales y locales) en la eficiencia diagnóstica y terapéutica de la osteoporosis en el Área de Salud de León = Implications of the use of the guidelines with the greater international impact (NOGG and NOF) and other guidelines (international, national and local) on the diagnostic and therapeutic efficiency of osteoporosis in the health area of León

Kyriakos¹

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The 2018 Guidelines for the diagnosis and treatment of osteoporosis in Greece

Cited by 37 publications

References 39 publications

Screening for osteoporosis: A systematic assessment of the quality and content of clinical practice guidelines, using the AGREE II instrument and the IOM Standards for Trustworthy Guidelines

Screening for osteoporosis: A systematic assessment of the quality and content of clinical practice guidelines, using the AGREE II instrument and the IOM Standards for Trustworthy Guidelines

Effect of vitamin K2 on bone mineral density and serum cathepsin K in female osteoporosis patients

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