Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children

Pediatric Rheumatology Online Journal

Mireia López-Corbeto¹  Jenaro Graña-Gil²  Juan Carlos Nieto-Gonzalez³  Berta Magallares-López⁴  Belén Sevilla-Pérez⁵  Rocío Galindo-Zavala⁶  Concepción Mir-Perelló⁷  Mª. Isabel González-Fernández⁸  Paula Alcañiz-Rodríguez⁹  Rosa Bou-Torrent^1,10  Almudena Román-Pascual^1,11  Marta Medrano-San Ildefonso^1,12  Natalia Palmou-Fontana^1,13 

[1] Servicio de Reumatología Hospital Vall d’Hebron;Servicio de Reumatología, Complejo Hospitalario Universitario A Coruña;Servicio de Reumatología, Hospital General Universitario Gregorio Marañón;Servicio de Reumatología, Hospital de la Santa Creu i Sant Pau;UGC Pediatría, Sección Reumatología Pediátrica, Hospital Campus de la Salud;UGC Pediatría. Sección Reumatología Pediátrica, Hospital Regional Universitario de Málaga;Unidad de Pediatría, Sección Reumatología Pediátrica, Hospital Universitari Son Espases;Unidad de Pediatría, Sección de Reumatología Pediátrica, Hospital La Fe;Unidad de Pediatría, Sección de Reumatología Pediátrica, Hospital Virgen de la Arriaxaca;Unidad de Reumatología Pediátrica, Hospital Sant Joan de Déu;Unidad de Reumatología, Hospital General de Villalba;Unidad de Reumatología, Hospital Miguel Servet;Unidad de Reumatología, Hospital Universitario Marqués de Valdecilla;

关键词: Secondary osteoporosis;    Children;    Low bone mineral density;   

DOI  :  10.1186/s12969-020-0411-9

来源: DOAJ

【 摘 要 】

Abstract Background Osteoporosis incidence in children is increasing due to the increased survival rate of patients suffering from chronic diseases and the increased use of drugs that can damage bones. Recent changes made to the definition of childhood osteoporosis, along with the lack of guidelines or national consensuses regarding its diagnosis and treatment, have resulted in a wide variability in the approaches used to treat this disease. For these reasons, the Osteogenesis Imperfecta and Childhood Osteoporosis Working Group of the Spanish Society of Pediatric Rheumatology has sounded the need for developing guidelines to standardize clinical practice with regard to this pathology. Methods An expert panel comprised of 6 pediatricians and 5 rheumatologists carried out a qualitative literature review and provided recommendations based on evidence, when that was available, or on their own experience. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A Delphi survey was conducted for those recommendations with an evidence level of IV or V. This survey was sent to all members of the SERPE. All recommendations that had a level of agreement higher or equal to 70% were included. Results Fifty-one recommendations, categorized into eight sections, were obtained. Twenty-four of them presented an evidence level 4 or 5, and therefore a Delphi survey was conducted. This was submitted electronically and received a response rate of 40%. All recommendations submitted to the Delphi round obtained a level of agreement of 70% or higher and were therefore accepted. Conclusion In summary, we present herein guidelines for the prevention, diagnosis and treatment of secondary childhood osteoporosis based on the available evidence and expert clinical experience. We believe it can serve as a useful tool that will contribute to the standardization of clinical practice for this pathology. Prophylactic measures, early diagnosis and a proper therapeutic approach are essential to improving bone health, not only in children and adolescents, but also in the adults they will become in the future.

【 授权许可】

Unknown