Guidance for the diagnosis, prevention and therapy of osteoporosis in Italy

Osteoporosis poses a significant public health issue. In recent years, International and National Societies have developed Guidelines for the diagnosis and treatment of this disorder, with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Società Italiana dell'Osteoporosi, del Metabolismo Minerale e delle Malattie dello Scheletro (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, risk-assessment, prevention and management of idiopathic postmenopausal osteoporosis, also focusing on male and secondary osteoporosis. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. Nonetheless, the practical management of osteoporosis is greatly influenced by economic reimbursement policies, particularly for secondary forms of osteoporosis. The refinement of risk assessment, the long-term treatment of osteoporosis and the prevention and management of disease-associated bone loss constitute open issues.