UK clinical guideline for the prevention and treatment of osteoporosis

Celia L Gregson; David J Armstrong; Jean Bowden; Cyrus Cooper; John Edwards; Neil J L Gittoes; Nicholas Harvey; John Kanis; Sarah Leyland; Rebecca Low; Eugene McCloskey; Katie Moss; Jane Parker; Zoe Paskins; Kenneth Poole; David M Reid; Mike Stone; Julia Thomson; Nic Vine; Juliet Compston

doi:10.1007/s11657-022-01061-5

UK clinical guideline for the prevention and treatment of osteoporosis

Arch Osteoporos. 2022 Apr 5;17(1):58. doi: 10.1007/s11657-022-01061-5.

Authors

Celia L Gregson^{1

2}, David J Armstrong³, Jean Bowden⁴, Cyrus Cooper^{5

6

7}, John Edwards⁸, Neil J L Gittoes⁹, Nicholas Harvey^{5

6}, John Kanis¹⁰, Sarah Leyland¹¹, Rebecca Low¹², Eugene McCloskey¹³, Katie Moss¹⁴, Jane Parker⁴, Zoe Paskins¹⁵, Kenneth Poole^{16

17}, David M Reid¹⁸, Mike Stone¹⁹, Julia Thomson¹¹, Nic Vine⁴, Juliet Compston²⁰

Affiliations

¹ Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK. [email protected].
² Royal United Hospital NHS Foundation Trust, Bath, UK. [email protected].
³ Western Health and Social Care Trust (NI), Nutrition Innovation Centre for Food and Health, Ulster University, and Visiting Professor, Belfast, Northern Ireland.
⁴ Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK.
⁵ MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
⁶ NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁷ NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
⁸ Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, and Wolstanton Medical Centre, Newcastle under Lyme, UK.
⁹ Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital, University Hospitals Birmingham & University of Birmingham, Birmingham, UK.
¹⁰ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia and Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
¹¹ Royal Osteoporosis Society, Bath, UK.
¹² Abingdon and Specialty Doctor in Metabolic Bone Disease, Marcham Road Health Centre, Nuffield Orthopaedic Centre, Oxford, UK.
¹³ Department of Oncology & Metabolism, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK.
¹⁴ St George's University Hospital, London, UK.
¹⁵ School of Medicine, Keele University, Keele, Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK.
¹⁶ Department of Medicine, University of Cambridge, Cambridge, UK.
¹⁷ NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
¹⁸ University of Aberdeen, Aberdeen, Scotland.
¹⁹ University Hospital Llandough, Cardiff and Vale University Health Board, Llandough, UK.
²⁰ University of Cambridge, School of Clinical Medicine, Cambridge, UK.

Abstract

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.

Keywords: Fracture; Guideline; NOGG; Osteoporosis.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Bone Density
Female
Fractures, Bone*
Humans
Male
Middle Aged
Osteoporosis* / diagnosis
Osteoporosis* / drug therapy
Osteoporosis* / prevention & control
Risk Assessment
United Kingdom / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding