Reumatismo 1/2016 1GUIDELINES
Reumatismo, 2016; 68 (1): 1-39
Guidelines for the diagnosis,
prevention and management
of osteoporosis
M. Rossini, S. Adami, F. Bertoldo, D. Diacinti, D. Gatti, S. Giannini,
A. Giusti, N. Malavolta, S. Minisola, G. Osella, M. Pedrazzoni,
L. Sinigaglia, O.Viapiana, G.C. Isaia
On behalf of the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)
with the endorsement of
Italian Society of Endocrinology (SIE)
Italian Society of Geriatrics and Gerontology (SIGG)
Italian Society of Internal Medicine (SIMI)
Italian Society of Rheumatology (SIR)
summary
Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the
diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the
peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and
Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, risk-
assessment, prevention and management of primary and secondary osteoporosis. The guidelines were first
drafted by a working group and then approved by the board of SIOMMMS.
Subsequently they received also the
endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations
are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness.
When minimal evidence is available, recommendations are based on leading experts’ experience and opinion,
and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk
factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits
overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables
susceptible to pharmacological effect. DeFRA (FRAX® derived fracture r
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