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      Adecuación del diagnóstico de osteoporosis en una consulta de atención primaria en el medio rural Translated title: Adaptation of the osteoporosis diagnosis in a rural setting primary care consultation

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          Clinical Practice. Postmenopausal Osteoporosis.

          Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.
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            FRAX Update

            The fracture risk assessment tool, FRAX, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, models are now available for 63 countries, covering 79% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide. However, the application of FRAX in guidelines has been heterogeneous with the adoption of several different approaches to setting intervention thresholds. The relationship between FRAX and efficacy of intervention has been explored and is expected to influence treatment guidelines in the future. A more unified approach to setting intervention thresholds with FRAX is a research priority.
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              A decade of FRAX: how has it changed the management of osteoporosis?

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                Author and article information

                Journal
                albacete
                Revista Clínica de Medicina de Familia
                Rev Clin Med Fam
                Sociedad Española de Medicina de Familia y Comunitaria (Barcelona, Cataluña, Spain )
                1699-695X
                2386-8201
                2023
                : 16
                : 3
                : 307-308
                Affiliations
                [2] Toledo orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1Gerencia de Atención Integrada de Talavera de la Reina orgdiv2Unidad de Apoyo a la Investigación España
                [1] Toledo orgnameServicio de Salud de Castilla-La Mancha (SESCAM) orgdiv1Gerencia de Atención Integrada de Talavera de la Reina orgdiv2Unidad de Docente Multiprofesional de Atención Familiar y Comunitaria España
                [3] Toledo orgnameServicio de Salud de Castilla-La Mancha orgdiv1Gerencia de Atención Integrada de Talavera de la Reina (SESCAM) orgdiv2Centro de Salud Los Navalmorales España
                Article
                S1699-695X2023000300014 S1699-695X(23)01600300014
                10.55783/rcmf.160314
                c0b56971-e2f9-4372-8f54-9016195cb775

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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