Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases

Journal article

El Miedany, Y., Abu-Zaid, M., El Gaafary, M., El Naby, M., Fathi N., Saber H., Hassan, W., Eissa M., Mohannad N., Khaled H., Mortada M., Nasef S., Galal, S., Ghaleb R., Tabra S., Mohamed S., Medhat B., Aly H., Elolemy G., Fouad N., Ganeb S., Adel Y., Ibrahim M., Farouk O. and Gadallah N. 2021. Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases. Egyptian Rheumatology and Rehabilitation. 48 (5). https://doi.org/10.1186/s43166-020-00056-9
AuthorsEl Miedany, Y., Abu-Zaid, M., El Gaafary, M., El Naby, M., Fathi N., Saber H., Hassan, W., Eissa M., Mohannad N., Khaled H., Mortada M., Nasef S., Galal, S., Ghaleb R., Tabra S., Mohamed S., Medhat B., Aly H., Elolemy G., Fouad N., Ganeb S., Adel Y., Ibrahim M., Farouk O. and Gadallah N.
Abstract

Background: This study was carried out to achieve an Egyptian expert consensus on a treat-to-target managementstrategy for osteoporosis using Delphi technique. A scientific committee identified researchers and clinicians with expertise in osteoporosis in Egypt. Delphi process was implemented (2 rounds) to establish a consensus on 15
clinical standards: (1) concept, (2) diagnosis, (3) case identification, (4) whom to treat, (5) who should treat?, (6) case stratification and intervention thresholds, (7) falls risk, (8) investigations, (9) treatment target, (10) management, (11) optimum treatment duration, (12) monitoring, (13) drug holiday, (14) osteoporosis in men, and (15) post-fracture care and fracture liaison service.

Results: The surveys were sent to an expert panel (n = 25), of whom 24 participated in the two rounds. Respondents were drawn from different governorates and health centres across Egypt including the Ministry of Health. Most of the participants were rheumatologists (76%), followed by internists (8%), orthopaedic doctors (4%), rehabilitation doctors (4%), primary care (4%), and ortho-geriatrics (4%) physicians. Seventy-two recommendations, categorised into 15 sections, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.4 to 100%. Consensus was reached (i.e. ≥ 75% of respondents strongly agreed or agreed) on the wording of all 15 clinical standards identified by the scientific committee. An algorithm for the management of postmenopausal osteoporosis has been suggested.

Conclusion: A wide and representative panel of experts established a consensus regarding the management of
osteoporosis in Egypt. The developed guidelines provide a comprehensive approach to the assessment and management of osteoporosis for all Egyptian healthcare professionals who are involved in its management.

KeywordsDelphi; Consensus; Guidelines; Egypt; Osteoporosis; Standards of care; Very high fracture risk; Bisphosphonates; Denosumab; Romosozumab; Egyptian Academy of Bone Health
Year2021
JournalEgyptian Rheumatology and Rehabilitation
Journal citation48 (5)
PublisherSpringer
ISSN1110-161X
2090-3235
Digital Object Identifier (DOI)https://doi.org/10.1186/s43166-020-00056-9
Official URLhttps://erar.springeropen.com/articles/10.1186/s43166-020-00056-9
Publication dates
Print28 Jan 2021
Publication process dates
Accepted23 Dec 2020
Deposited16 Jun 2022
Publisher's version
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Output statusPublished
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