Update of the S3-guideline on diagnostics, prophylaxis and treatment of osteoporosis
Abstract
With the aid of a new fracture risk model, the great treatment gap for osteoporosis should be closed. All patients older than 70 years should undergo a diagnostic procedure for osteoporosis. An additional risk threshold (≥ 10% per 3 years for femoral and vertebral fractures) should enable patients with a high risk of fracture to be treated with osteoanabolic agents. The use of osteoanabolic agents makes it necessary to administer antiresorptive drugs afterwards. Due to the low event rate of osteonecrosis of the jaw, the initiation of a specific osteoporosis treatment should not be delayed by prophylactic dental treatment. The adherence to the drug treatment should be improved by an individualized approach on the basis of a cooperation between patients, caregivers, and physicians. A regular assessment of falls, including the timed up and go test should be carried out in patients older than 70 years.
Mithilfe eines neuen Frakturrisikomodells soll der großen Behandlungslücke der Osteoporose entgegengewirkt werden. Patientinnen und Patienten ab dem 70. Lebensjahr sollten eine Osteoporosediagnostik erhalten. Eine zusätzliche Risikoschwelle soll ermöglichen, dass Patienten bei sehr hohem Frakturrisiko (≥ 10 % pro 3 Jahre für Femur- und Wirbelkörperfrakturen) mit osteoanabolen Präparaten behandelt werden. Der Einsatz von osteoanabolen Präparaten erfordert im Therapieverlauf eine antiresorptive Anschlusstherapie. Der Beginn einer spezifischen Osteoporosetherapie soll wegen der…
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