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Pediatric Rheumatology
Published in: Pediatric Rheumatology 1/2020

01-12-2020 | Bisphosphonate | Research article

Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children

Authors: Rocío Galindo-Zavala, Rosa Bou-Torrent, Berta Magallares-López, Concepción Mir-Perelló, Natalia Palmou-Fontana, Belén Sevilla-Pérez, Marta Medrano-San Ildefonso, Mª. Isabel González-Fernández, Almudena Román-Pascual, Paula Alcañiz-Rodríguez, Juan Carlos Nieto-Gonzalez, Mireia López-Corbeto, Jenaro Graña-Gil

Published in: Pediatric Rheumatology | Issue 1/2020

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Abstract

Background

Osteoporosis incidence in children is increasing due to the increased survival rate of patients suffering from chronic diseases and the increased use of drugs that can damage bones.
Recent changes made to the definition of childhood osteoporosis, along with the lack of guidelines or national consensuses regarding its diagnosis and treatment, have resulted in a wide variability in the approaches used to treat this disease.
For these reasons, the Osteogenesis Imperfecta and Childhood Osteoporosis Working Group of the Spanish Society of Pediatric Rheumatology has sounded the need for developing guidelines to standardize clinical practice with regard to this pathology.

Methods

An expert panel comprised of 6 pediatricians and 5 rheumatologists carried out a qualitative literature review and provided recommendations based on evidence, when that was available, or on their own experience.
The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A Delphi survey was conducted for those recommendations with an evidence level of IV or V. This survey was sent to all members of the SERPE. All recommendations that had a level of agreement higher or equal to 70% were included.

Results

Fifty-one recommendations, categorized into eight sections, were obtained. Twenty-four of them presented an evidence level 4 or 5, and therefore a Delphi survey was conducted. This was submitted electronically and received a response rate of 40%. All recommendations submitted to the Delphi round obtained a level of agreement of 70% or higher and were therefore accepted.

Conclusion

In summary, we present herein guidelines for the prevention, diagnosis and treatment of secondary childhood osteoporosis based on the available evidence and expert clinical experience. We believe it can serve as a useful tool that will contribute to the standardization of clinical practice for this pathology. Prophylactic measures, early diagnosis and a proper therapeutic approach are essential to improving bone health, not only in children and adolescents, but also in the adults they will become in the future.
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Metadata
Title
Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children
Authors
Rocío Galindo-Zavala
Rosa Bou-Torrent
Berta Magallares-López
Concepción Mir-Perelló
Natalia Palmou-Fontana
Belén Sevilla-Pérez
Marta Medrano-San Ildefonso
Mª. Isabel González-Fernández
Almudena Román-Pascual
Paula Alcañiz-Rodríguez
Juan Carlos Nieto-Gonzalez
Mireia López-Corbeto
Jenaro Graña-Gil
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2020
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-020-0411-9

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