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. 2021 Jun 26;16(1):102.
doi: 10.1007/s11657-021-00954-1.

The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults

Sanjay K Bhadada  1 , Manoj Chadha  2 , Usha Sriram  3 , Rimesh Pal  4 , Thomas V Paul  5 , Rajesh Khadgawat  6 , Ameya Joshi  7 , Beena Bansal  8 , Nitin Kapoor  5 , Anshita Aggarwal  9 , Mahendra K Garg  10 , Nikhil Tandon  6 , Sushil Gupta  11 , Narendra Kotwal  12 , Shriraam Mahadevan  13 , Satinath Mukhopadhyay  14 , Soham Mukherjee  4 , Subhash C Kukreja  15 , Sudhaker D Rao  16 , Ambrish Mithal  17
Affiliations

The Indian Society for Bone and Mineral Research (ISBMR) position statement for the diagnosis and treatment of osteoporosis in adults

Sanjay K Bhadada et al. Arch Osteoporos. .

Abstract

The Indian Society for Bone and Mineral Research (ISBMR) has herein drafted clinical practice guidelines for the diagnosis and management of osteoporosis for the people of India. Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

Purpose: In India, osteoporosis is a major public health problem. However, in the absence of any robust regional guidelines, the screening, treatment, and follow-up of patients with osteoporosis are lagging behind in the country.

Methods: The Indian Society for Bone and Mineral Research (ISBMR), which is a multidisciplinary group of physicians, researchers, dietitians, and epidemiologists and who study bone and related tissues, in their annual meeting, drafted the guidelines for the diagnosis and management of osteoporosis that would be appropriate in a resource constraint setting like India.

Results: Diagnosis of osteoporosis can be made in a patient with minimal trauma fracture without the aid of any other diagnostic tools. In others, bone mineral density measured by dual-energy X-ray absorptiometry remains the modality of choice. Data indicates that osteoporotic fractures occur at an earlier age in Indians than in the West; hence, screening for osteoporosis should begin at an earlier age. FRAX can be used for fracture risk estimation; however, it may underestimate the risk of future fractures in our population and still needs validation. Maintaining optimum serum 25-hydroxyvitamin D levels is essential, which, in most cases, would require regular vitamin D supplementation. Pharmacotherapy should be guided by the presence/absence of vertebral/hip fractures or the severity of risk based on clinical factors, although bisphosphonates remain the first choice in most cases. Regular follow-up is essential to ensure adherence and response to therapy.

Conclusions: Implementation of the position statement in clinical practice is expected to improve the overall care of patients with osteoporosis in India.

Keywords: Fracture prevention; Guidelines; ISBMR; India; Osteoporosis.

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