Artrite Idiopática Juvenil
Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis – 2018 update
Background: Advances in osteoporosis(OP) case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated tte Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007.
Methods: SPR bone diseases’ working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts’ opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey.
Results: The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed.
Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people.
Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations – clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
Neste artigo, os autores apresentam as recomendações para o diagnóstico e terapêutica da osteoporose (OP), elaboradas pela Sociedade Portuguesa de Reumatologia (SPR) e pela Sociedade Portuguesa de Doenças Ósseas Metabólicas (SPODOM).
O documento resultou do consenso estabelecido após revisão de bibliografia, reuniões de trabalho e discussão aberta em reuniões promovidas pela SPR e pela SPODOM. As recomendações são apresentadas com discussão de pontos que abordam a definição de OP, avaliação clínica dos doentes, factores de risco de OP e identificação dos indivíduos com risco elevado de fractura, utilização, indicações e interpretação da absorciometria radiológica de dupla energia (DEXA), avaliação complementar na abordagem inicial da OP, prevenção e tratamento da OP pós-menopáusica e da osteoporose masculina. Estas recomendações visam reduzir o risco e a frequência de fracturas osteoporóticas, através de práticas clínicas validadas que permitam uma utilização eficaz dos recursos diagnósticos e terapêuticos disponíveis. Os consensos serão revistos sempre que novas evidências o justificarem.