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Osteoporose – Definition, Risikoerfassung, Diagnose, Prävention und Therapie (Update 2024)

  • Hans Peter Dimai,
  • Christian Muschitz,
  • Karin Amrein,
  • Rosemarie Bauer,
  • Daniel Cejka,
  • Rudolf Wolfgang Gasser,
  • Reinhard Gruber,
  • Judith Haschka,
  • Timothy Hasenöhrl,
  • Franz Kainberger,
  • Katharina Kerschan-Schindl,
  • Roland Kocijan,
  • Jürgen König,
  • Norbert Kroißenbrunner,
  • Ulrike Kuchler,
  • Christine Oberforcher,
  • Johannes Ott,
  • Georg Pfeiler,
  • Peter Pietschmann,
  • Paul Puchwein,
  • Alexander Schmidt-Ilsinger,
  • Ralf Harun Zwick,
  • Astrid Fahrleitner-Pammer

摘要

Background

Austria is among the countries with the highest incidence and prevalence of osteoporotic fractures worldwide. Guidelines for the prevention and management of osteoporosis were first published in 2010 under the auspices of the then Federation of Austrian Social Security Institutions and updated in 2017. The present comprehensively updated guidelines of the Austrian Society for Bone and Mineral Research are aimed at physicians of all specialties as well as decision makers and institutions in the Austrian healthcare system. The aim of these guidelines is to strengthen and improve the quality of medical care of patients with osteoporosis and osteoporotic fractures in Austria.

Methods

These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1 June 2023 into consideration. The grading of recommendations used (“conditional” and “strong”) are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV).

Results

The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening.

Conclusion

The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system.