Because individual clinicians cannot systematically collect all the evidence bearing on the efficacy of osteoporosis therapies, they require summaries for NCT-501 ic50 consistent therapeutic patterns [3]. As recommended by the recently published European guidance for the diagnosis and management of osteoporosis in postmenopausal women [4], nation-specific guidelines are needed to take into consideration the specificities of each and every health care environment. The present document is the result of a national consensus, based on a systematic review and a critical appraisal of the currently available literature. It offers an evidence-based update to previous Belgian Bone Club treatment guidelines [5], with the aim of providing
clinicians with an unbiased assessment of osteoporosis treatment effect. Currently in Belgium, reimbursement of antiosteoporosis medications is granted to postmenopausal AR-13324 chemical structure women with low bone mineral density (BMD; T-score < −2.5 at the lumbar spine or at the hip) or with a prevalent vertebral fracture. Nevertheless, taking into account the new development of validated tools, assessing the 10-year absolute fracture risk of postmenopausal women, based on the presence of clinical risk factors, it can reasonability be expected that within a few months or years, reimbursement of antiosteoporosis medications
will be open to all women who really deserve treatment [6, 7]. These guidelines address only postmenopausal women, and glucocorticoid-induced osteoporosis is not included. Whereas most compounds have proven to significantly reduce the occurrence of vertebral fractures, discrepancies remain regarding the level of evidence related to their nonvertebral or hip antifracture effect. Methods This paper expands and updates our previously published Consensus [5]. We included meta-analyses or randomized controlled trials (RCTs) in postmenopausal women, comparing interventions currently registered in Belgium for the management of osteoporosis with a placebo. However, for some registered drugs like calcitonin and etidronate, the
reader is referred to our previous Consensus publication [5] because no new data have been generated since and because these drugs are no longer considered first-line treatment options for the management of osteoporosis. The intervention could be given tuclazepam in conjunction with a calcium and vitamin D supplement, provided the comparison group received the same supplements. Furthermore, the results had to be reported with a follow-up of at least 1 year on one or more of the outcomes of interest: radiological or clinical evidence of fractures of the vertebra, wrist, or hip. We searched MEDLINE from 1966 to 2009 and databases such as the Cochrane Controlled Register for citations of relevant articles. After this extensive search of the literature, a critical appraisal of the data was obtained through a consensus check details experts meeting.