2010 Guidelines

2010 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada

Papaioannou A, et al.

CMAJ

2010 Oct 12. [Epub ahead of print].

Introduction and Key Changes to the Guidelines

Section One

2010 Guidelines Development of the Guidelines

• • • Key stakeholders were surveyed to identify priorities Systematic literature reviews were conducted in two key areas – Fracture risk assessment – Therapies for osteoporosis Graded recommendations were developed based on these reviews Papaioannou A, et al.

CMAJ

2010 Oct 12. [Epub ahead of print].

2010 Guidelines Target Population

• • Women and men > 50 years of age Other fracture-risk groups are beyond the scope of these guidelines Papaioannou A, et al.

CMAJ

2010 Oct 12. [Epub ahead of print].

2010 Guidelines

•

Key Changes from 2002 1 to 2010 2 : Fracture Risk Assessment

10-year fracture risk prediction tools incorporate clinical risk factors beyond BMD for improved clinical decision making: – CAROC: Joint initiative of the Canadian Association of Radiologists and Osteoporosis Canada 3

OR

– FRAX: Fracture Risk Assessment Tool developed by the World Health Organization 4 1. Brown JP, Josse RG.

CMAJ

2. Papaioannou A, et al.

CMAJ

2002; 167(10 Suppl):S1-34. 2010 Oct 12. [Epub ahead of print]..

3. Leslie WD, Berger C, Langsetmo L, et al.

Osteoporos Int

. In press.

4. Leslie WD, Lix LM, Langsetmo L, et al.

Osteoporos Int

. In press.

2010 Guidelines Key Changes from 2002 1 to 2010 2

• • Increased focus on the clinical impact of fragility fractures Increased focus on the care gap that exists in the identification and treatment of high-risk individuals 1. Brown JP, Josse RG.

CMAJ

2. Papaioannou A, et al.

CMAJ

2002; 167(10 Suppl):S1-34. 2010 Oct 12. [Epub ahead of print].

2010 Guidelines Key Changes from 2002 1 to 2010 2 (cont’d)

• • • Higher daily vitamin D supplementation (D3) 3 – – 400 – 1000 IU for individuals < 50 years 800 – 2000 IU for individuals > 50 years Lower daily calcium intake (from all sources): 1200 mg Updated evidence-based approach to therapies 1. Brown JP, Josse RG.

CMAJ

2. Papaioannou A, et al.

CMAJ

2002; 167(10 Suppl):S1-34. 2010 Oct 12. [Epub ahead of print].

3. Hanley DA, et al.

CMAJ

2010; 182: E610-E618.