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dc.contributor.author Nogués Solan, Francesc Xavier
dc.contributor.author Nolla, J.M.
dc.contributor.author Casado, Enrique
dc.contributor.author Jódar, E.
dc.contributor.author Muñoz-Torres, Mónica
dc.contributor.author Quesada-Gómez, J.M.
dc.contributor.author Canals, L.
dc.contributor.author Balcells, Mercedes
dc.contributor.author Lizán, Luis
dc.date.accessioned 2018-07-11T07:51:18Z
dc.date.available 2018-07-11T07:51:18Z
dc.date.issued 2018
dc.identifier.citation Nogués X, Nolla JM, Casado E, Jódar E, Muñoz-Torres M, Quesada-Gómez JM, et al. Spanish consensus on treat to target for osteoporosis. Osteoporos Int. 2018 Feb;29(2):489-499. DOI: 10.1007/s00198-017-4310-y
dc.identifier.issn 0937-941X
dc.identifier.uri http://hdl.handle.net/10230/35121
dc.description.abstract 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. INTRODUCTION: The paper aims to achieve a Spanish expert consensus on a treat-to-target (T2T) strategy in osteoporosis. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Osteoporosis International. 2018 Feb;29(2):489-99
dc.rights Copyright © The Author(s) 2017. Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.subject.other Osteoporosi -- Tractament
dc.title Spanish consensus on treat to target for osteoporosis
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1007/s00198-017-4310-y
dc.subject.keyword Management
dc.subject.keyword Osteoporosis
dc.subject.keyword Osteoporosis care
dc.subject.keyword Treat to target
dc.subject.keyword Treat-to-target strategy
dc.subject.keyword Treatment
dc.subject.keyword Treatment failure
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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