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Joint Bone Spine. 2018 Oct;85(5):519-530. doi: 10.1016/j.jbspin.2018.02.009. Epub 2018 Apr 11.

2018 update of French recommendations on the management of postmenopausal osteoporosis.

Author information

1
Service de rhumatologie, hôpital Cochin, 27, rue de Faubourg Saint-Jacques, 75014 Paris, France. Electronic address: karine.briot@aphp.fr.
2
Service de rhumatologie, hôpital Cochin, 27, rue de Faubourg Saint-Jacques, 75014 Paris, France.
3
Inserm U1059, service de rhumatologie, CHU de Saint-Etienne, 42100 Saint-Etienne, France.
4
Unité de soins aigus gériatriques, centre Antonin-Balmes, CHU de Montpellier, université Montpellier 1, 34090 Montpellier, France.
5
Médecine générale, 87032 Limoges, France.
6
Inserm U1033, service de rhumatologie, université de Lyon, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon, France.
7
Service de rhumatologie, CHU de Poitiers, 86021 Poitiers, France.
8
Service de chirurgie orthopédique de l'hôpital Saint-Antoine, hôpitaux universitaires Est-Parisiens, 75012 Paris, France.
9
Centre de médecine gériatrique, CHR de Orléans, 45000 Orléans, France.
10
Inserm U1241, Inra U1341, institut NUMECAN, 35000 Rennes, France; Service de rhumatologie, CHU, hôpital Sud, 35000 Rennes, France; Université de Rennes 1, 35000 Rennes, France.
11
Service de rhumatologie, CHU de Angers, 49000 Angers, France.
12
Médecine générale, 37000 Tours, France.
13
Service de rhumatologie, CHR Orléans, 45000 Orléans, France.
14
Centre de ménopause, hôpital Paule-de-Viguier, 31300 Toulouse, France.
15
Service d'endocrinologie, CHU de Nancy, 54000 Nancy, France.
16
EA 4490, service de rhumatologie, CHU de Lille, 59000 Lille, France.

Abstract

OBJECTIVES:

To update the 2012 recommendations on pharmacotherapy for postmenopausal osteoporosis, under the aegis of the Bone Task Force of the French Society for Rheumatology (SFR) and of the Osteoporosis Research and Information Group (GRIO), in collaboration with scientific societies (Collège national des généralistes enseignants, Collège national des gynécologues et obstétriciens français, Fédération nationale des collèges de gynécologie médicale, Groupe d'étude de la ménopause et du vieillissement hormonal, Société française de chirurgie orthopédique, Société française d'endocrinologie, and Société française de gériatrie et de gérontologie).

METHODS:

Updated recommendations were developed by a task force whose members represented the medical specialties involved in the management of postmenopausal osteoporosis. The update was based on a literature review and developed using the method advocated by the French National Authority for Health (HAS).

DISCUSSION AND CONCLUSION:

The updated recommendations place strong emphasis on the treatment of women with severe fractures, in whom the use of osteoporosis medications is recommended. All the available osteoporosis medications are suitable in patients with severe fractures; zoledronic acid deserves preference as the fist-line drug after a hip fracture. In patients with or without non-severe fractures, the decision to use osteoporosis medications is based on bone mineral density values and in challenging cases, on probabilities supplied by prediction tools such as FRAX®. All osteoporosis medications are suitable; raloxifene should be reserved for patients at low risk for peripheral fractures. The fracture risk should be reevaluated every 2 to 3 years to decide on the best follow-up treatment. These updated recommendations discuss the selection of first-line osteoporosis medications and treatment sequences.

KEYWORDS:

Bone absorptiometry; FRAX; Fracture; Menopause; Osteoporosis; Recommendations

PMID:
29654947
DOI:
10.1016/j.jbspin.2018.02.009
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