IOF recognises ESCEO European Guidance for Osteoporosis Diagnosis and Management

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A comprehensive guide to applying new FRAX tool and WHO technical report in European daily practice

The International Osteoporosis Foundation (IOF) has welcomed the recently published paper European guidance for the diagnosis and management of osteoporosis in postmenopausal women1 from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

This paper constitutes a roadmap for European countries to practically implement the new FRAXTM tool based on the WHO technical report, Assessment of osteoporosis at the primary health care level2,3. The European guidance, published in Osteoporosis International, is a critical review of diagnostic methods, treatments and their monitoring options. It also shows case-finding strategies supported by health economic data.

IOF sees the ESCEO guidance as a positive move towards using the FRAXTM algorithm in daily practice. The WHO report and FRAXTM tool, released on February 21, 2008, help health practitioners to better understand the new paradigm for diagnosis and management of people at risk of developing fragility fractures.

In this regard, there will be a FRAXTM exhibition booth at the forthcoming ECCEO 8 Congress in Istanbul, Turkey, to be held at the Grand Cevahir Hotel & Convention Center. Participants will have the opportunity to have their 10-year fracture risk calculated, based on their geographic origin and individual risk factors. As a next step, the ESCEO paper can contribute with guidance on how to manage or monitor their condition, in the most rationale and cost-effective way.

Professor Jean-Yves Reginster, President of ESCEO, noted, “The ESCEO European guidance is convergent with the WHO report on how to assess and treat postmenopausal women with or at risk from osteoporosis. Moreover, cost-effectiveness analyses which illustrate scenarios based on a UK setting provide a starting point for health policy makers and health care providers to develop national guidelines on diagnosis and intervention thresholds.”

The ESCEO guidance is very timely, as across Europe, osteoporosis is a major public health problem with serious medical and economic impact. In 2000, throughout the region, there were an estimated 620,000 new hip fractures, 574,000 forearm fractures, 250,000 shoulder fractures, and 620,000 spinal fractures in men and women aged 50 years or over, accounting for 34.8% of such fractures worldwide4. There are more than 2.7 million osteoporotic fractures in men and women in Europe at a direct cost of 36 billion euros5. It is estimated that by 2050, direct costs related to hip fractures will increase to 76.7 billion euros6.

References

1. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster, JY, Borgström F, Rizzoli R, on behalf of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008 Feb 12; [Epub ahead of print]
2. Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases. University of Sheffield, UK.
3. World Health Organization. Assessment of osteoporosis at the primary health care level. Summary Report of a WHO Scientific Group. WHO, Geneva. www.who.int/chp/topics/rheumatic/en/index.html
4. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733
5. Kanis JA, Johnell O, on behalf of the Committee of Scientific Advisors of the International Osteoporosis Foundation (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:220–238
6. Kanis JA et al. Requirements for DXA for the management of Osteoporosis in Europe. Osteoporosis Int. 2005;16:229-38)