Guidelines: October 12, 2010

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Alexandra Papaioannou MD MSc, Suzanne Morin MD MSc, Angela M. Cheung MD PhD, Stephanie Atkinson PhD, Jacques P. Brown MD, Sidney Feldman MD, David A. Hanley MD, Anthony Hodsman MD, Sophie A. Jamal MD PhD, Stephanie M. Kaiser MD, Brent Kvern MD, Kerry Siminoski MD, William D. Leslie MD MSc; for the Scientific Advisory Council of Osteoporosis Canada.

CMAJ 2010, October 1-10. DOI:10.1503/cmaj.100771

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Since the publication of the Osteoporosis Canada guidelines in 2002, there has been a paradigm shift in the prevention and treatment of osteoporosis and fractures.The focus now is on preventing fragility fractures and their negative consequences, rather than on treating low bone mineral density, which is viewed as only one of several risk factors for fracture. Given that certain clinical factors increase the risk of fracture independent of bone mineral density, it is important to take an integrated approach and to base treatment decisions on the absolute risk of fracture.

Current data suggest that many patients with fractures do not undergo appropriate assessment or treatment. To address this care gap for high-risk patients, the 2010 guidelines concentrate on the assessment and management of women and men over age 50 who are at high risk of fragility fractures and the integration of new tools for assessing the 10-year risk of fracture into overall management.