Sanjay K Bhadada1, Manoj Chadha2, Usha Sriram3, Rimesh Pal4, Thomas V Paul5, Rajesh Khadgawat6, Ameya Joshi7, Beena Bansal8, Nitin Kapoor5, Anshita Aggarwal9, Mahendra K Garg10, Nikhil Tandon6, Sushil Gupta11, Narendra Kotwal12, Shriraam Mahadevan13, Satinath Mukhopadhyay14, Soham Mukherjee4, Subhash C Kukreja15, Sudhaker D Rao16, Ambrish Mithal17. 1. Department of Endocrinology, Post Graduate Institute Of Medical Education and Research, Chandigarh, 160012, India. bhadadask@rediffmail.com. 2. Department of Endocrinology, Parmanand Deepchand Hinduja Hospital, Mumbai, 400016, India. 3. Endocrinology and Diabetology Division, Voluntary Health Services Hospital, Chennai, 600020, India. 4. Department of Endocrinology, Post Graduate Institute Of Medical Education and Research, Chandigarh, 160012, India. 5. Department of Endocrinology, Christian Medical College, Vellore, 632002, India. 6. Department of Endocrinology, All India Institute Of Medical Sciences, New Delhi, 110023, India. 7. Endocrinology Division, Bhaktivedanta Hospital, Thane, 401107, India. 8. Endocrinology and Diabetes Division, Door to Care, Gurgaon, 122018, India. 9. Department of Endocrinology, Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India. 10. Department of Endocrinology, All India Institute Of Medical Sciences, Jodhpur, 342001, India. 11. Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India. 12. Department of Endocrinology, Army Hospital Research & Referral, New Delhi, 110010, India. 13. Endocrinology Division, Sri Ramachandra Medical Center, Chennai, 600116, India. 14. Department of Endocrinology, Institute of Post-Graduate Medical Education and Research, Kolkata, 700020, India. 15. Department of Medicine, University of Illinois, Chicago, IL, 60612, USA. 16. Department of Internal Medicine, Division of Endocrinology, Diabetes and Bone & Mineral Disorders, Henry Ford, Health System, Detroit, MI, 48202, USA. 17. Endocrinology and Diabetes Division, Max Healthcare, New Delhi, 110017, India. ambrishmithal@hotmail.com.
Abstract
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.
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.
Authors: R K Marwaha; N Tandon; M K Garg; R Kanwar; A Narang; A Sastry; A Saberwal; K Bhadra; A Mithal Journal: Osteoporos Int Date: 2011-01-27 Impact factor: 4.507
Authors: Sujata V Vaidya; Veena H Ekbote; Anuradha V Khadilkar; Shashi A Chiplonkar; Deepa Pillay; Uma Divate Journal: Endocr Res Date: 2011-10-11 Impact factor: 1.720
Authors: Antresa Jose; Kripa Elizabeth Cherian; Munaf Babajan Nandyal; Stephen A Jiwanmall; Dheeraj Kattula; Thomas V Paul; Nitin Kapoor Journal: Med Sci (Basel) Date: 2021-11-09
Authors: Julie Shlisky; Rubina Mandlik; Sufia Askari; Steven Abrams; Jose M Belizan; Megan W Bourassa; Gabriela Cormick; Amalia Driller-Colangelo; Filomena Gomes; Anuradha Khadilkar; Victor Owino; John M Pettifor; Ziaul H Rana; Daniel E Roth; Connie Weaver Journal: Ann N Y Acad Sci Date: 2022-03-05 Impact factor: 6.499