|KANIS, JOHN - University Of Sheffield
|MCCLOSKEY, EUGENE - University Of Sheffield
|HARVEY, NICHOLAS - University Of Southampton
|COOPER, CYRUS - University Of Southampton
|RIZZOLI, RENE - University Of Geneva
|DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
|MAGGI, STEFANIA - Consiglio Nazionale Delle Ricerche
|REGINSTER, JEAN-YVES - Who-Collaborating Centre For Epidemiology Of Musculoskeletal Conditions And Ageing
Submitted to: Aging Clinical Experimental Research
Publication Type: Other
Publication Acceptance Date: 7/29/2022
Publication Date: 11/7/2022
Citation: Kanis, J.A., Mccloskey, E.V., Harvey, N.C., Cooper, C., Rizzoli, R., Dawson-Hughes, B., Maggi, S., Reginster, J. 2022. Intervention thresholds and diagnostic thresholds in the management of osteoporosis. Aging Clinical Experimental Research. https://doi.org/10.1007/s40520-022-02216-7.
Technical Abstract: The World Health Organization (WHO) bone mineral density (BMD)-based operational definition of osteoporosis has yielded a regulatory framework in the USA, the European Union, and elsewhere that has permitted development of important therapeutic interventions. The low rate of treatment in patients who have sustained a fragility fracture appears to underlie recent calls for a change in the diagnostic criteria for osteoporosis, but there is little evidence that this alone would improve management in such patients. In contrast, there is increasing evidence that the implementation of fracture liaison services through campaigns such as Capture the Fracture can improve access to better management and treatment of patients with osteoporosis. It is widely recognised that BMD alone for fracture risk assessment is less sensitive than risk assessment that incorporate risk indicators in addition to BMD. We recommend that the BMD-based definition of osteoporosis be retained whilst further clarity is brought to bear on the distinction between BMD-based diagnoses and intervention thresholds.