[DVO guideline 2006. What changes have there been in the diagnosis, prevention and treatment of osteoporosis?].

The main changes in the updated DVO guideline 2006 on prevention, diagnosis and treatment of osteoporosis in postmenopausal women and in older men concern the evaluation of individual fracture risks and the selection of medicamentous therapy by means of new thresholds. A 30% risk of osteoporotic vertebral or hip fracture per decade is recommended as the threshold for implementation of pharmacological therapy. Evaluation of the individual absolute fracture risk is based on a combination of the results of densitometry at the lumbar spine and femur, age, gender, and other risk factors that are specifically associated with osteoporosis. Patient's mobility is assessed by carrying out special mobility tests. Further changes seen in the 2006 update of the DVO guideline are therapy proposals taking account of new pharmaceutical developments. New effective medications are rh-PTH (1-34), or teriparatide, strontium ranelate, and ibandronate (bisphosphonate) for monthly oral administration. Minimally invasive operative techniques for use in vertebral fractures in combination with medicamentous antiosteoporosis therapy are also included in the 2006 update of the DVO guideline. Thus, in the 2006 update of the DVO-guideline we have a practice-oriented 53 guideline that is adapted to individual fracture risk and gives recommendations on the prevention, diagnosis and treatment of osteoporosis.