GP osteoporosis guideline gets ‘significant’ update

Bone health

By Geir O'Rourke

3 Apr 2024

New recommendations around the use of fracture risk assessment tools, the removal of strontium as a therapy and fracture risk terminology are among the key changes in the latest osteoporosis guidelines for GPs.

Released last week, the Osteoporosis management and fracture prevention in postmenopausal women and men over 50 years of age, 3rd edition, has been described as a significant update over the 2nd edition, which was published back in 2017.

Other key updates in the new edition include fresh advice on the risk of rebound vertebral fracture following denosumab cessation, the importance of calcium and vitamin D status and the use of osteoanabolic therapies.

Beyond that, a ‘special issues’ section addresses latest guidance on delayed dental healing and the management of bone health patients undergoing androgen deprivation therapy for prostate cancer or aromatase inhibitor treatment for breast cancer.

The guideline review committee was chaired by Healthy Bones Australia medical director Associate Professor Peter Wong, who said areas of osteoporosis management had evolved significantly since the second edition.

He said Healthy Bones Australia and the RACGP were committed to providing the most up-to-date advice for GPs and practice teams across Australia.

“Osteoporosis is a serious chronic disease which can lead to fractures. This new edition reflects latest peer reviewed evidence and focuses on optimal management of osteoporosis in the community,” he said.

“GPs have a range of effective solutions available to tackle this health issue and the new edition provides clear guidance and recommendations on pharmacological management, including use of osteoanabolic therapies, use of fracture risk assessment tools, and the importance of calcium and vitamin D status in patients.”

“Each section in this new edition has been reviewed and updated with current peer-reviewed evidence by a bone expert with subspeciality expertise, to give GPs the highest standard of guidance and information.”

Evidence base

RACGP expert committee on quality care chair Professor Mark Morgan said that the guide included the best available advice for the management of this condition.

“This guide will make a real difference in the care and treatment of people with osteoporosis,” he said.

“It provides clear, evidence-based recommendations to help GPs care for patients aged 50 and over with poor bone health, including osteopenia and osteoporosis. We know our GPs do a tremendous job helping patients with these conditions and those at risk of developing them, and this guidance can act as a useful, extra tool to support clinical judgment on a patient by patient basis.

“The latest edition includes information on preventing first fractures, early diagnosis of osteoporosis that allows superior bone health management before a patient’s condition deteriorates, identifying the condition in undiagnosed patients following an initial fracture to prevent subsequent fractures, and the management of secondary causes of poor bone health.”

The guidelines are published on the RACGP website (link here).

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