Spanish consensus on treat to target for osteoporosis
| Autor: | Nogués, X., Nolla, J. M., Casado, E., Jódar, E., Muñoz-Torres, M., Quesada-Gómez, J. M., Canals, L., Balcells, M., Lizán, L., Universitat Autònoma de Barcelona |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
FRAX Delphi Technique Medication Therapy Management Endocrinology Diabetes and Metabolism Osteoporosis care Osteoporosis 030209 endocrinology & metabolism Therapeutics Drug Administration Schedule Likert scale 03 medical and health sciences Tratamiento médico 0302 clinical medicine Bone Density Osteoporosi -- Tractament medicine Teriparatide Humans computer.programming_language Femoral neck 030203 arthritis & rheumatology Bone Density Conservation Agents business.industry Treat-to-target strategy Osteoporosi Treat to target medicine.disease Terapèutica Management Treatment medicine.anatomical_structure Denosumab Treatment failure Spain Orthopedic surgery Physical therapy Original Article business computer Enfermedad Delphi Osteoporotic Fractures medicine.drug |
| Zdroj: | ABACUS. Repositorio de Producción Científica Universidad Europea (UEM) Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Osteoporosis International Dipòsit Digital de la UB Universidad de Barcelona Repositori Universitat Jaume I Universitat Jaume I |
| Popis: | Altres ajuts: The project received financial support from Amgen S.A. to conduct the study. LC and MB work at Amgen S.A. and hold stock in Amgen. LL works at a Life Science Boutique that received funding from Amgen S.A. to coordinate and conduct the study and to write up the manuscript. MMT has received research grants from UCB and MSD; is a consultant for Amgen, Lilly, and UCB; and speakers' bureau member for Amgen and Lilly. EJ has received research grants from Amgen, Lilly, and MSD and consulting fees from Amgen, UCB, and Lilly. XN has received research grants from Lilly and Amgen; is a consultant for Lilly and Amgen; and speakers' bureau member for Lilly, Amgen, and MSD. JMN is a consultant for Abbvie, Amgen, BMS, Gebro, Lilly, MSD, Roche, Sandoz, and UCB and speakers' bureau member for Abbvie, Amgen, BMS, Gebro, Lilly, MSD, Roche, and UCB. JMQ has received research grants from Amgen, Lilly, FIS Carlos III, RETICEF, and Intensification of Investigation Junta de Andalucía; is a consultant for Amgen, MSD, Italfarmaco, and FAES; and speakers' bureau member for Amgen, MSD, Italfarmaco, and FAES. EC has participated in the speakers' bureau for Amgen, Lilly, MSD, FAES, and Rubió. All authors declare that all the results presented in the manuscript are the true expression of findings and there has been no interference in respondents' free communication and dissemination. To reach a Spanish expert consensus on a treat-to-target strategy in osteoporosis, a Delphi Consensus Study has been developed. Most of the experts (59.8%) were rheumatologist with a mean clinical experience of 21.3 years (SD 8.5). Consensus was achieved for 70% of the items. Therapeutic objectives, patient follow-up scheme, treatment failure criteria, and appropriate treatment choice for use in T2T strategy in Spain have been defined. The paper aims to achieve a Spanish expert consensus on a treat-to-target (T2T) strategy in osteoporosis. A scientific committee led the project and was involved in expert panel identification and Delphi questionnaire development. Two Delphi rounds were completed. The first-round questionnaire included 24 items and assessed, using a seven-point Likert scale, the experts' wish (W) and prognosis (P) in 5 years for each topic (applicability, therapeutic objectives, patient follow-up, and possible treatment to be prescribed). Items for which there was no consensus in the first round were included in the second round. Consensus was defined as ≥75% agreement (somewhat/mostly/entirely agree) or disagreement (somewhat/mostly/entirely disagree) responses. Of the experts, 112 and 106 completed the first and second rounds, respectively. 59.8% were rheumatologists with a mean clinical experience of 21.3 years (SD 8.5). Consensus was achieved for 70% of the items, and was established regarding the utility of a T2T strategy to define therapeutic objectives, optimal follow-up, and therapeutic algorithm. Participants agreed on the utility of the bone mineral density (BMD) value (T-score >−2.5 SD for spine and >−2.5/−2.0 SD for femoral neck), lack of fractures, and fracture risk (FRAX) as therapeutic objectives. For measuring BMD changes, consensus was achieved on the suitability of hip and femoral neck locations. Experts agreed to consider treatment failure as when a significant BMD gain could not be achieved, or when a new fracture occurs within 2-3 years. There was consensus that all proposed therapies should achieve a therapeutic target through T2T strategy (treatments with the highest consensus scores were denosumab and teriparatide). The therapeutic objectives, patient follow-up scheme, treatment failure criteria, and appropriate treatment choice for use in T2T strategy in Spain have been established by a panel of experts. Some aspects nevertheless still require further analysis. |
| Databáze: | OpenAIRE |
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