Osteoporosis in 12 questions

• Type: Another Publication in an International Scientific Journal
• Date: 2016

Authors

Saavedra, A (Author) Other; Freitas, P (Author) FMUP; Carvalho Braga, D (Author) Other; Carvalho, Davide (Author) FMUP

Journal

Title: Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

Vol. 11

Pages: 296-306

ISSN: 1646-3439

Indexing

ISI Web of Knowledge - 0 Citations

Other information

Authenticus ID: P-00K-WSY

DOI: 10.1016/j.rpedm.2016.02.010

Abstract (EN): Introduction: Osteoporosis is the most common metabolic bone disease, affecting mainly postmenopausal women and older men. Aim: Answer to 12 key questions regarding osteoporosis diagnosis and treatment. Methods: Literature search in Medline database. References of the selected articles were revised and the most relevant articles were also included. Conclusions: 1 - What is osteoporosis? It is characterized by low bone mass and deterioration of micro architecture, with increased bone fragility and risk of fractures. 2 - What are the clinical manifestations? It is clinically silent until fracture occurs. 3 - What are the risk factors? The main factor is low bone mineral density (assessed by dual energy X-ray absorptiometry - DXA), but others contribute to the overall risk of fracture. 4 - What are the secondary causes? Metabolic, endocrine, gastrointestinal, connective tissue diseases or drugs. They are more common in premenopausal women and men. 5 - Who should be screened? All individuals over 50 years should be evaluated for the presence of clinical risk factors. 6 How to screen? By identification of risk factors that suggest performing DXA. 7 - How frequently should DXA be repeated? It varies with the result of the previous test and the probability of bone loss. 8 - How to evaluate osteoporotic patients? Evaluate all patients clinically and perform exams to exclude secondary causes and select the most appropriate pharmacological treatment. Some may require specific tests. 9 Who should be treated? The treatment is indicated according to the risk of fracture (calculated by FRAX tool). 10 - How to treat? Primary prevention measures are recommended since childhood. Several drugs have demonstrated efficacy, being addressed the indications to each of them. 11 - How long to treat? The optimal duration remains uncertain, being suggested the concept of "drug holiday". 12 - How to monitor? Perform DXA 1 to 2 years after starting treatment. Bone biomarkers, although promising, are not recommended. (C) 2016 Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Published by Elsevier Espafia, S.L.U.

Language: Portuguese

Type (Professor's evaluation): Scientific

No. of pages: 11