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01-12-2021 | Bisphosphonate | Position Paper

The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults

Authors: Sanjay K. Bhadada, Manoj Chadha, Usha Sriram, Rimesh Pal, Thomas V. Paul, Rajesh Khadgawat, Ameya Joshi, Beena Bansal, Nitin Kapoor, Anshita Aggarwal, Mahendra K. Garg, Nikhil Tandon, Sushil Gupta, Narendra Kotwal, Shriraam Mahadevan, Satinath Mukhopadhyay, Soham Mukherjee, Subhash C. Kukreja, Sudhaker D. Rao, Ambrish Mithal

Published in: Archives of Osteoporosis | Issue 1/2021

Abstract

Summary

The Indian Society for Bone and Mineral Research (ISBMR) has herein drafted clinical practice guidelines for the diagnosis and management of osteoporosis for the people of India. Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

Purpose

In India, osteoporosis is a major public health problem. However, in the absence of any robust regional guidelines, the screening, treatment, and follow-up of patients with osteoporosis are lagging behind in the country.

Methods

The Indian Society for Bone and Mineral Research (ISBMR), which is a multidisciplinary group of physicians, researchers, dietitians, and epidemiologists and who study bone and related tissues, in their annual meeting, drafted the guidelines for the diagnosis and management of osteoporosis that would be appropriate in a resource constraint setting like India.

Results

Diagnosis of osteoporosis can be made in a patient with minimal trauma fracture without the aid of any other diagnostic tools. In others, bone mineral density measured by dual-energy X-ray absorptiometry remains the modality of choice. Data indicates that osteoporotic fractures occur at an earlier age in Indians than in the West; hence, screening for osteoporosis should begin at an earlier age. FRAX can be used for fracture risk estimation; however, it may underestimate the risk of future fractures in our population and still needs validation. Maintaining optimum serum 25-hydroxyvitamin D levels is essential, which, in most cases, would require regular vitamin D supplementation. Pharmacotherapy should be guided by the presence/absence of vertebral/hip fractures or the severity of risk based on clinical factors, although bisphosphonates remain the first choice in most cases. Regular follow-up is essential to ensure adherence and response to therapy.

Conclusions

Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

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Title: The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults
Authors: Sanjay K. Bhadada
Manoj Chadha
Usha Sriram
Rimesh Pal
Thomas V. Paul
Rajesh Khadgawat
Ameya Joshi
Beena Bansal
Nitin Kapoor
Anshita Aggarwal
Mahendra K. Garg
Nikhil Tandon
Sushil Gupta
Narendra Kotwal
Shriraam Mahadevan
Satinath Mukhopadhyay
Soham Mukherjee
Subhash C. Kukreja
Sudhaker D. Rao
Ambrish Mithal
Publication date: 01-12-2021
Publisher: Springer London
Keywords: Bisphosphonate
Osteoporosis
Osteoporosis
Denosumab
Denosumab
Published in: Archives of Osteoporosis / Issue 1/2021
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-021-00954-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults

Abstract

Summary

Purpose

Methods

Results

Conclusions

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Springer Medicine

Abstract

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Annual out-of-pocket expenditure associated with healthcare use among Australian older women with osteoporosis: a cross-sectional study

Malleolar fracture in pregnancy and lactation-associated osteoporosis: a case report and literature review

How does proximal femur BMD of healthy Irish adults compare to NHANES III? Results of the DXA-HIP Project