Abstract
Historically, osteoporosis has been viewed as a disease of women, with research, trials of interventions and guidelines predominantly focused as such. It is apparent, however, that this condition causes a substantial health burden in men also, and that its assessment and management must ultimately be addressed across both sexes. In this article, an international multidisciplinary working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases presents GRADE-assessed recommendations for the diagnosis, monitoring and treatment of osteoporosis in men. The recommendations are based on a comprehensive review of the latest research related to diagnostic and screening approaches for osteoporosis and its associated high fracture risk in men, covering disease burden, appropriate interpretation of bone densitometry (including the use of a female reference database for densitometric diagnosis in men) and absolute fracture risk, thresholds for treatment, and interventions that can be used therapeutically and their health economic evaluation. Future work should specifically address the efficacy of anti-osteoporosis medications, including denosumab and bone-forming therapies.
| Original language | English |
|---|---|
| Pages (from-to) | 241-251 |
| Number of pages | 11 |
| Journal | Nature Reviews. Rheumatology |
| Volume | 20 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2024 |
Funding
The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group that produced this Evidence-Based Guideline was funded by the ESCEO. The ESCEO receives unrestricted educational grants to support its educational and scientific activities from non-governmental organisations, not-for-profit organisations, non-commercial or corporate partners. The choice of topics, participants, content and agenda of the working group as well as the writing, editing, submission and reviewing of the manuscript are the sole responsibility of the ESCEO, without any influence from third parties. The authors wish to thank and acknowledge their patient partners who provided expert patient input and insight. N.R.F. declares that he has received travel bursaries from Eli Lilly and Pfizer and speaker’s fees from Viatris outside the submitted work. B.A. declares that he has received speaker and/or consulting fees from UCB, Amgen, Kyowa-Kirin, and Pharmacosmos, and institutional research grants (with funds paid to the institution) from Novartis, Kyowa-Kirin and Pharmacosmos; he is a member of the Executive Committee of the European Calcified Tissue Society. O.B. declares that he has received consulting or lecture fees from Amgen, Aptissen, Biophytis, IBSA, Mylan, Novartis, Orifarm, Sanofi, UCB and Viatris outside the submitted work. B.C. declares that he has received personal fees, consultancy, lecture fees and/or honoraria from Alexion, Amgen, Expansience, Kyowa-Kirin, MSD, Novartis,Theramex, UCB, Viatris. M.C. declares that she has received honoraria from Kyowa Kirin and AMGEN for speaking and chairing engagements. W.D. declares that he is a shareholder and former employee of Amgen, and former board of director member of Radius Health. M.H. declares that he has received research grants (paid to his institution) from Radius Health and Amgen, consulting fees from UCB and lecture fees from Mylan Pharmaceuticals and IBSA (paid to his institution), outside this work. J.A.K. declares that he is a director of Osteoporosis Research Ltd, a member of the National Osteoporosis Guideline Group (UK), a member of the International Osteoporosis Foundation, and a member of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). J.M.K. declares that he is a board member (treasurer) of ESCEO. S.M. declares that she has received research grants and personal fees as an advisory board member and/or speaker fees from GSK, Pfizer, Merck, Sanofi, Takeda, Novavax, Viatris and Janssen outside the submitted work. R.M. declares that she has received personal fees from Amicus, ElPharma, Abela Pharm. A.K. declares that he has participated in advisory boards for Amgen, UCB, Agnovos, Alexion, Image Biopsy Lab, Theramex and speakers bureau for Amgen, Merit Medical, UCB, Agnovos, Alexion, Theramex, Stada; he is president of the Dachverband Osteologie e.V., Germany. M.M.R. declares that he is a Member of the Scientific Advice Working Party and Member of the Central Nervous System Working Party at the European Medicines Agency. S.Si. declares that he has received grant support from Amgen, consultancy fees from Amgen and Radius. N.V. declares that she has received personal fees from IBSA, Mylan, Viatris, Fidia, MSD, Bayer outside this work. R.R. declares that he has received fees as a speaker or consultant for Abiogen, Effryx, Nestlé, ObsEva and Theramex. C.C. declares that he has received personal fees from ABBH, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier and Takeda. J.Y.R. declares that he has received consulting fees or been on paid advisory boards for IBSA-Genevrier, Mylan, Radius Health, Pierre Fabre, Faes Pharma, Rejuvenate Biomed, Samumed, Teva, Theramex, Pfizer, Mithra Pharmaceuticals, received lecture fees when speaking at the invitation of the sponsor for IBSA-Genevrier, Mylan, Cniel, Dairy Research Council (DRC), Nutricia, Danone, Agnovos and received grant support from IBSA-Genevrier, Mylan, Cniel, Radius Health, TRB. N.C.H. declares that he has received personal fees, consultancy, lecture fees and/or honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, UCB, Kyowa Kirin, Servier, Shire, Consilient Healthcare, Theramex and Internis Pharma. The other authors declare no competing interests.
| Funders | Funder number |
|---|---|
| European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases | |
| ESCEO | |
| Amgen |
