Spanish consensus on treat to target for osteoporosis

Summary: 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 ob...

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Autores: Nogués, X., Nolla, Joan M., Casado, Enrique, Jódar Gimeno, José Esteban, Muñoz Torres, Manuel, Quesada Gómez, José Manuel, Canals, L., Balcells, M., Lizán Tudela, L.
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/7192
Acceso en línea:http://hdl.handle.net/11268/7192
Access Level:acceso abierto
Palabra clave:Osteoporosis
Tratamiento médico
Enfermedad
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spelling Spanish consensus on treat to target for osteoporosisNogués, X.Nolla, Joan M.Casado, EnriqueJódar Gimeno, José EstebanMuñoz Torres, ManuelQuesada Gómez, José ManuelCanals, L.Balcells, M.Lizán Tudela, L.OsteoporosisTratamiento médicoEnfermedadSummary: 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.20182018-04-0620182018-01-0120182018-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articlehttp://hdl.handle.net/11268/7192reponame:ABACUS. Repositorio de Producción Científicainstname:Universidad Europea (UEM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:abacus.universidadeuropea.com:11268/71922026-06-11T12:41:27Z
dc.title.none.fl_str_mv Spanish consensus on treat to target for osteoporosis
title Spanish consensus on treat to target for osteoporosis
spellingShingle Spanish consensus on treat to target for osteoporosis
Nogués, X.
Osteoporosis
Tratamiento médico
Enfermedad
title_short Spanish consensus on treat to target for osteoporosis
title_full Spanish consensus on treat to target for osteoporosis
title_fullStr Spanish consensus on treat to target for osteoporosis
title_full_unstemmed Spanish consensus on treat to target for osteoporosis
title_sort Spanish consensus on treat to target for osteoporosis
dc.creator.none.fl_str_mv Nogués, X.
Nolla, Joan M.
Casado, Enrique
Jódar Gimeno, José Esteban
Muñoz Torres, Manuel
Quesada Gómez, José Manuel
Canals, L.
Balcells, M.
Lizán Tudela, L.
author Nogués, X.
author_facet Nogués, X.
Nolla, Joan M.
Casado, Enrique
Jódar Gimeno, José Esteban
Muñoz Torres, Manuel
Quesada Gómez, José Manuel
Canals, L.
Balcells, M.
Lizán Tudela, L.
author_role author
author2 Nolla, Joan M.
Casado, Enrique
Jódar Gimeno, José Esteban
Muñoz Torres, Manuel
Quesada Gómez, José Manuel
Canals, L.
Balcells, M.
Lizán Tudela, L.
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Osteoporosis
Tratamiento médico
Enfermedad
topic Osteoporosis
Tratamiento médico
Enfermedad
description Summary: 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.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-04-06
2018
2018-01-01
2018
2018-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/11268/7192
url http://hdl.handle.net/11268/7192
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:ABACUS. Repositorio de Producción Científica
instname:Universidad Europea (UEM)
instname_str Universidad Europea (UEM)
reponame_str ABACUS. Repositorio de Producción Científica
collection ABACUS. Repositorio de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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