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UK clinical guideline for the prevention and treatment of osteoporosis

UK clinical guideline for the prevention and treatment of osteoporosis
UK clinical guideline for the prevention and treatment of osteoporosis
Summary: The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management. Introduction: The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Methods: Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Results: Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, and models of care for fracture prevention. Recommendations are made for training; service leads and commissioners of healthcare; and for review criteria for audit and quality improvement. Conclusion: The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.
Fracture, Guideline, NOGG, Osteoporosis
1862-3522
Gregson, Celia L.
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Armstrong, David J.
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Bowden, Jean
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Cooper, Cyrus
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Edwards, John
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Gittoes, Neil J L.
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Harvey, Nicholas
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Kanis, John A.
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Leyland, Sarah
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Low, Rebecca
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McCloskey, Eugene
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Moss, Katie
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Parker, Jane
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Paskins, Zoe
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Poole, Kenneth E.S.
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Reid, David M.
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Stone, Mike
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Thomson, Julia
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Vine, Nic
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Compston, Juliet
ffd1eb66-ec4f-45b9-9340-04520c456c52
et al.
Gregson, Celia L.
30fae822-e733-4e67-b11a-e46dfb1b269a
Armstrong, David J.
1436a3cd-339c-4634-9d0c-7579f6c7f176
Bowden, Jean
82ef88f9-0daa-43b1-be1f-9a7b57bd5d56
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Edwards, John
ab4400a6-450d-47ac-8966-00bd8d8bbe06
Gittoes, Neil J L.
77c22cfa-943c-4c0e-9163-ff9f2e193ba1
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Leyland, Sarah
e6dd6698-569c-481f-af9d-e3ffcde68ee3
Low, Rebecca
ccee0a00-98f2-472d-a4a1-61468db89f1c
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Moss, Katie
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Parker, Jane
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Paskins, Zoe
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Poole, Kenneth E.S.
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Reid, David M.
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Stone, Mike
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Thomson, Julia
bfc30138-d3c7-439e-b4a7-c44140c0e0f1
Vine, Nic
5493f86d-0af0-460e-b3c6-941a81099b00
Compston, Juliet
ffd1eb66-ec4f-45b9-9340-04520c456c52

Gregson, Celia L., Armstrong, David J., Bowden, Jean, Cooper, Cyrus and Harvey, Nicholas , et al. (2022) UK clinical guideline for the prevention and treatment of osteoporosis. Archives of Osteoporosis, 17 (1), [58]. (doi:10.1007/s11657-022-01061-5).

Record type: Article

Abstract

Summary: The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management. Introduction: The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Methods: Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. Results: Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, and models of care for fracture prevention. Recommendations are made for training; service leads and commissioners of healthcare; and for review criteria for audit and quality improvement. Conclusion: The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.

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Manuscript NOGG Guideline 2021-12-20 - Accepted Manuscript
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Accepted/In Press date: 3 January 2022
Published date: 5 April 2022
Additional Information: 19 May 2022A Correction to this paper has been published: https://doi.org/10.1007/s11657-022-01115-8 Funding Information: NOGG are grateful to our external peer reviewers, stakeholders, and the Committee of Scientific Advisors of the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases for their endorsement of this manuscript. Funding Information: The National Osteoporosis Guideline Group (NOGG) Guideline Writing Group is divided into two groups, a Guideline Development Group (GDG) and an Expert Advisory Group (EAG). The GDG consists of 8 voting members (CLG, JC, JE, JK, RL, SL, ZP, JT), and 3 lay members (JB, JP, NV). One member has a financial disclosure, unrelated to drug development (JC received honoraria for speaking at a CME approved bone academy meeting and for consultancy relating to the characterisation of people at very high fracture risk), the remaining 10 have no financial disclosures. ZP is funded by the National Institute for Health Research (NIHR) (Clinician Scientist Award (CS-2018–18-ST2-010)/NIHR Academy). ZP has undertaken consultancy for non-promotional activities for UCB and waived any rights to any fees. One member (JK) is also a member of the FRAX group, hence all FRAX-based recommendations had to be agreed by consensus of all the GDG. The Chair (CLG) has no disclosures. The EAG is composed of 9 members, all of whom have relevant conflicts of interest. DA has received advisory/speaking fees from UCB and Internis Pharma and has shares in GSK. CC has received advisory/speaking fees from Amgen, Danone, Eli Lilly, GSK, Kyowa Kirin, Medtronic, Merck, Nestle, Novartis, Pfizer, Roche, Servier, Shire, Takeda, and UCB. NG is on the advisory board of UCB, Novo Nordisk, Shire/Takeda and has received fees from UCB and Takeda. NCH has received advisory board/consultancy fees/honoraria from Alliance for Better Bone Health, Amgen, MSD, Eli Lilly, UCB, Radius, Servier, Shire, Consilient Healthcare, and Internis Pharma. EMC has received advisory/honoraria from Amgen, Consilient Healthcare, Kyowa Kirin, Eli Lilly, Fresenius Kabi, Internis, ObsEva, Radius Inc and Redx Pharma and received research funding from Amgen, Internis, and Radius Inc. KM has received conference sponsorship from Abbvie, UCB, Novartis, Kyowa Kirin, Lilly, Pfizer, and Internis, and advisory/honoraria from Alexion. KP received advisory/speaker fees from UCB which were then donated to charities. DR has received advisory fees from UCB and Osteolabs. MS has received advisory/speaker fees from UCB, and speaker fees from Amgen and Gedeon Richter. All members of the GDG and EAG have read NICE’s ‘Policy on declaring and managing interests for NICE advisory boards’ (version 1.1, July 2019). Disclosures of all members of both groups are available on the NOGG website. Both the GDG and the EAG attend online meetings and take part in email discussions. However, voting on the recommendations is restricted to the GDG. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright:© 2022, The Author(s).
Keywords: Fracture, Guideline, NOGG, Osteoporosis

Identifiers

Local EPrints ID: 456625
URI: http://eprints.soton.ac.uk/id/eprint/456625
ISSN: 1862-3522
PURE UUID: 27bef4f5-bf75-407a-9d91-5f9fa66bea50
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 05 May 2022 16:57
Last modified: 18 Mar 2024 02:59

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Contributors

Author: Celia L. Gregson
Author: David J. Armstrong
Author: Jean Bowden
Author: Cyrus Cooper ORCID iD
Author: John Edwards
Author: Neil J L. Gittoes
Author: Nicholas Harvey ORCID iD
Author: John A. Kanis
Author: Sarah Leyland
Author: Rebecca Low
Author: Eugene McCloskey
Author: Katie Moss
Author: Jane Parker
Author: Zoe Paskins
Author: Kenneth E.S. Poole
Author: David M. Reid
Author: Mike Stone
Author: Julia Thomson
Author: Nic Vine
Author: Juliet Compston
Corporate Author: et al.

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