Updated European guidance for the diagnosis and management of osteoporosis in women

The clinical significance of osteoporosis lies in the painful, debilitating fractures that arise, which are a major cause of long-term disability in the population. Nevertheless, osteoporosis is under-diagnosed and undertreated: in the European Union, it is estimated that 57 % of women at high risk of fragility fracture due to osteoporosis do not receive bone-specific treatment. In patients with fragility fractures, less than 20 % receive treatment to reduce the chance of a future fracture.

The International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) have published an updated guidance to aid healthcare professionals in diagnosing and managing osteoporosis in postmenopausal women. The present guidance reviews and updates the 2013 guidance in all key areas and includes new information on the evaluation of bone microstructure in fracture risk assessment, the role of FRAX and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment.

Endorsed by the Scientific Advisory Board of ESCEO as well as the Committees of Scientific Advisors and National Societies of the IOF, the recommendations in this guideline are intended for all healthcare professionals involved in the management of osteoporosis.

"This new guidance aims to stimulate a cohesive approach to the management of osteoporosis in Europe by providing an updated platform on which specific guidelines can be developed or revised at a national level," explains Professor John Kanis, Honorary President of IOF.

Professor Jean-Yves Reginster, ESCEO President and Chair of the IOF Committee of National Societies, concludes: "Although this guidance has a European perspective and is focussed on postmenopausal women, the recommendations can be of assistance in other regions of the world and in men. The hope is that the recommendations will facilitate improved prevention and management for at-risk individuals and ultimately serve to alleviate the high societal and personal costs posed by osteoporosis to healthcare systems and patients with osteoporosis."

In addition to the full guidance in Osteoporosis International, executive summaries will be published in Calcified Tissue International and Aging Clinical and Experimental Research.