Clinical practice guidelines for optimizing bone health in Korean children and adolescents

Abstract

The Committee on Pediatric Bone Health of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for optimizing bone health in Korean children and adolescents. These guidelines present recommendations based on the Grading of Recommendations, which includes the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines include processes of bone acquisition, definition, and evaluation of low bone mineral density (BMD), causes of osteoporosis, methods for optimizing bone health, and pharmacological treatments for enhancing BMD in children and adolescents. While these guidelines provide current evidence-based recommendations, further research is required to strengthen these guidelines.

Keywords: Adolescent; Bone; Child; Korea; Practice guidelines.

Fig. 1.

The algorithm for assessment of bone health in children and adolescents. BUN, blood urea nitrogen; Cr, creatinine; PTH, parathyroid hormone; DXA, dual-energy x-ray absorptiometry; BMD, bone mineral density; Tx, treatment.

Fig. 2.

(A) Bisphosphonate treatment in patients with osteogenesis imperfecta (OI). (B) Bisphosphonate treatment in patients with secondary osteoporosis. DXA, dualenergy x-ray absorptiometry; BMD, bone mineral density; Tx, treatment. ^*Pamidronate 9 mg/kg/yr, 4–6 divided doses or zoledronate 0.1 mg/kg/yr, 2 divided doses. ^†Initial Tx of bisphosphonate, pamidronate 9 mg/kg/year, 4-6 divided doses or zoledronate 0.1 mg/kg/year, 2 divided doses. ^‡Maintenance Tx, pamidronate 3 mg/kg/yr in 2 divided doses or zoledronate 0.025 mg/kg annually. Modified from Simm et al. J Paediatr Child Health 2018;54:223-33, with permission of Paediatrics and Child Health Division (The Royal Australasian College of Physicians) [54].