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Z Orthop Unfall 2016; 154(03): 237-244
DOI: 10.1055/s-0041-110813
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Osteoporose: leitliniengerechte Diagnostik und Therapie

Osteoporosis: Diagnostics and Therapy According to the German Guidelines
C. Niedhart
Orthopädische Praxis, Heinsberg
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Publication History

Publication Date:
04 February 2016 (online)

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Zusammenfassung

Seit 2003 existiert eine S3-Leitlinie zur Diagnostik und Therapie der Osteoporose. Die letzte Aktualisierung erfolgte im Jahr 2014. Ziel dieses Artikels ist die Darstellung des notwendigen Wissens zur Diagnostik und Therapie der primären Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen. Hierbei wird der Inhalt der aktualisierten Leitlinie [1] vorgestellt, kommentiert sowie aktuelle Literatur seit Erscheinen der Leitlinie zusätzlich dargestellt. Sowohl Kurz- als auch Langfassung der Leitlinie sind im Internet unter „www.dv-osteologie.org“ abrufbar.

Abstract

The S3 guideline on the diagnosis and therapy of osteoporosis has existed since 2003. This was last updated in 2014. The aim of the present article is to present the knowledge needed for the diagnosis and therapy in men aged 60 or more and in postmenopausal women. The contexts of the updated guideline [1] are presented, together with comments on recent literature that has appeared since the last version. Both abbreviated and long versions of the guideline are available in the Internet under “www.dv-osteologie.org”.

Schlüsselwörter

Osteoporose - Leitlinie - Diagnostik - Therapie

Key words

osteoporosis - guideline - treatment - diagnostic
 

  • Literatur

  • 1 Dachverband Osteologie e.V. (DVO). DVO-Leitlinie zur Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen (13.11.2014).. Im Internet: http://www.dv-osteologie.de Stand: 13.11.2014
    PubMed
  • 2 [Anonymous] Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993; 94: 646-650
    CrossrefPubMedSearch in Google Scholar
  • 3 Kanis JA on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK. 2007: Printed by the University of Sheffield. World Health Organization: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843. Geneva: WHO; 1994
    Search in Google Scholar
  • 4 Scheidt-Nave C, Banzer D, Abendroth K. Schlussbericht Multizentrische Studie zu Verteilung, Determination und prädiktivem Wert der Knochendichte in der deutschen Bevölkerung. Förderprojekt des Bundesministeriums für Forschung und Technologie, Förderkennzeichen 01KM 9304/0. 1997: 1-45
    PubMedSearch in Google Scholar
  • 5 Icks A, Haastert B, Wildner M et al. Trend of hip fracture incidence in Germany 1995–2004: a population-based study. Osteoporos Int 2008; 19: 1139-1145
    CrossrefPubMedSearch in Google Scholar
  • 6 Costa A, Wyman A, Siris ES et al. When, Where and How Osteoporosis-Associated Fractures Occur: An Analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW). PLoS One 2013; 8: e83306
    CrossrefPubMedSearch in Google Scholar
  • 7 Schilling S. Epidemic vitamin D deficiency among patients in an elderly care rehabilitation facility. Dtsch Arztebl Int 2012; 109: 33-38
    PubMedSearch in Google Scholar
  • 8 Borgstrom F, Zethraeus N, Johnell O et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int 2006; 17: 637-650
    CrossrefPubMedSearch in Google Scholar
  • 9 Eriksen EF, Lyles KW, Colón-Emeric CS et al. Antifracture efficacy and reduction of mortality in relation to timing of first dose of zoledronic acid after hip fracture. J Bone Miner Res 2009; 24: 1308-1313
    CrossrefPubMedSearch in Google Scholar
  • 10 Bolland MJ, Grey AB, Gamble GD, Reid IR. Effect of osteoporosis treatment on mortality: a meta-analysis. J Clin Endocrinol Metab 2010; 95: 1174-1181
    CrossrefPubMedSearch in Google Scholar
  • 11 Kanis JA, Johnell O, Oden A et al. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 2001; 12: 989-995
    CrossrefPubMedSearch in Google Scholar
  • 12 Cummings SR, Cawthon PM, Ensrud KE et al. BMD and risk of hip and nonvertebral fractures in older men: a prospective study and comparison with older women. J Bone Miner Res 2006; 21: 1550-1556
    CrossrefPubMedSearch in Google Scholar
  • 13 Johnell O, Kanis JA, Oden A et al. Fracture risk following an osteoporotic fracture. Osteoporos Int 2004; 15: 175-179
    CrossrefPubMedSearch in Google Scholar
  • 14 Howe TE, Shea B, Dawson LJ et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 2011; (7) CD000333
    PubMedSearch in Google Scholar
  • 15 Lai JK, Lucas RM, Armstrong M et al. Prospective observational study of physical functioning, physical activity, and time outdoors and the risk of hip fracture: a population-based cohort study of 158,057 older adults in the 45 and up study. J Bone Miner Res 2013; 28: 2222-2231
    CrossrefPubMedSearch in Google Scholar
  • 16 Kemmler W, Häberle L, von Stengel S. Effects of exercise on fracture reduction in older adults: a systematic review and meta-analysis. Osteoporos Int 2013; 24: 1937-1950
    CrossrefPubMedSearch in Google Scholar
  • 17 Cummings SR, San Martin J, McClung MR et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009; 361: 756-765
    CrossrefPubMedSearch in Google Scholar
  • 18 Bone HG, Chapurlat R, Brandi ML et al. The effect of 3 or 6 years of denosumab exposure in women with postmenopausal osteoporosis: results from the FREEDOM extension. J Bone Miner Res 2012; 27: 694-701
    CrossrefPubMedSearch in Google Scholar
  • 19 Abrahamsen B, Eiken P, Eastell R. Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis. J Clin Endocrinol Metab 2010; 95: 5258-5265
    CrossrefPubMedSearch in Google Scholar
  • 20 Schilcher J, Michaelsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med 2011; 364: 1728-1737
    CrossrefPubMedSearch in Google Scholar
  • 21 Khan AA, Morrison A, Hanley DA et al. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015; 30: 3-23
    CrossrefPubMedSearch in Google Scholar
  • 22 Hadji P, Zanchetta JR, Russo L et al. The effect of teriparatide compared with risedronate on reduction of back pain in postmenopausal women with osteoporotic vertebral fractures. Osteoporos Int 2012; 23: 2141-2150
    CrossrefPubMedSearch in Google Scholar
  • 23 Saag KG, Shane E, Boonen S et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357: 2028-2039
    CrossrefPubMedSearch in Google Scholar
  • 24 Nakamura T, Matsumoto T, Sugimoto T et al. Clinical Trials Express: fracture risk reduction with denosumab in Japanese postmenopausal women and men with osteoporosis: denosumab fracture intervention randomized placebo controlled trial (DIRECT). J Clin Endocrinol Metab 2014; 99: 2599-2607
    CrossrefPubMedSearch in Google Scholar
  • 25 Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with the use of morphine and opiates. J Intern Med 2006; 260: 76-87
    CrossrefPubMedSearch in Google Scholar
  • 26 Pfeifer M, Begerow B, Minne HW. Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil 2004; 83: 177-186
    CrossrefPubMedSearch in Google Scholar
  • 27 Guo JB, Zhu Y, Chen BL et al. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis. PLoS One 2015; 10: e0127145
    CrossrefPubMedSearch in Google Scholar