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Title: | Is a treat-to-target strategy in osteoporosis applicable in clinical practice? Consensus among a panel of European experts | Authors: | Thomas, T. Casado, E. GEUSENS, Piet Lems, W. F. Timoshanko, J. Taylor, D. Hofbauer, L. C. |
Issue Date: | 2020 | Publisher: | SPRINGER LONDON LTD | Source: | Osteoporosis international, 31 (12) , p. 2303 -2311 | Abstract: | A panel of European experts was convened to establish consensus on a treat-to-target strategy in osteoporosis. Panellists agreed that the ultimate goals of treating osteoporosis are recovering pre-fracture functional level and reducing subsequent fracture risk; there was consensus that total hip bone mineral density is currently the most appropriate treatment target in clinical practice. Introduction A modified Delphi approach was convened to establish consensus among European experts on best practice management for patients with fragility fractures and whether a treat-to-target (T2T) strategy is applicable in osteoporosis. Methods A panel of 12 clinical experts (from eight European countries) voted on 13 final statements relating to a T2T strategy for osteoporosis across three rounds of blinded, remotely conducted electronic surveys (Likert scale: 'strongly disagree', 'disagree', 'unable to answer', 'agree', 'strongly agree'). When panellists disagreed, they were asked how the statement could be adjusted to allow for a positive response, which was used to refine the statement for the following round. Consensus was defined as >= 75% agreement with a statement. Panellists were selected by UCB Pharma, which provided financial and logistical support. Results Consensus was reached for 13/13 statements. Panellists agreed that the most important goals for fragility fracture patients are recovery of pre-fracture functional level and reduction of subsequent fracture risk. There was also consensus that a T2T strategy is applicable to osteoporosis and that bone mineral density (BMD) is currently the most clinically appropriate target. With regard to the definition of a specific BMD treatment target and timeframes applicable to T2T in osteoporosis, no clear consensus was reached; panellists emphasised that these would need to be individually determined. Conclusions According to a panel of European experts, the main goals of fracture management are to recover pre-fracture functional level and reduce fracture risk. Total hip BMD seems to be the most clinically appropriate treatment target within a T2T strategy. | Notes: | Timoshanko, J (corresponding author), UCB Pharma, Slough, Berks, England. jen.timoshanko@ucb.com |
Other: | Timoshanko, J (corresponding author), UCB Pharma, Slough, Berks, England. jen.timoshanko@ucb.com | Keywords: | Bone mineral density;Delphi panel;Fragility fracture;Osteoporosis;Treat-to-target | Document URI: | http://hdl.handle.net/1942/32758 | ISSN: | 0937-941X | e-ISSN: | 1433-2965 | DOI: | 10.1007/s00198-020-05569-9 | ISI #: | WOS:000557134200002 | Rights: | The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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