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Meta-Analysis
. 2023 May 22;18(1):75.
doi: 10.1007/s11657-023-01242-w.

Diagnosis and management of osteoporosis in Saudi Arabia: 2023 key updates from the Saudi Osteoporosis Society

Yousef Al-Saleh  1   2 , Riad Sulimani  3 , Shaun Sabico  4 , Fahad M Alshahrani  5   6 , Mona A Fouda  3 , Mohammed Almohaya  7 , Salwa B Alaidarous  8   9   10 , Hazem M Alkhawashki  11 , Mohammed Alshaker  12 , Hanan Alrayes  13 , Najla Saleh  5   6 , Nasser M Al-Daghri  4
Affiliations
Meta-Analysis

Diagnosis and management of osteoporosis in Saudi Arabia: 2023 key updates from the Saudi Osteoporosis Society

Yousef Al-Saleh et al. Arch Osteoporos. .

Abstract

The Saudi Osteoporosis Society (SOS) has updated its guidelines for the diagnosis and management of osteoporosis in Saudi Arabia (SA), with emphasis on postmenopausal women. This document is relevant to all healthcare professionals in SA involved in the care of patients with osteoporosis and osteoporosis-related fractures.

Introduction: The SOS launched the first national osteoporosis guidelines in 2015 and spearheaded the Gulf Cooperation Council Countries (GCC) osteoporosis consensus report in 2020 which was under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO). This paper highlights a major update of the guidelines in the SA setting.

Methods: This guideline is an adaptation of the current guidelines derived from ESCEO, the American Association of Clinical Endocrinologists (AACE), and the GCC osteoporosis consensus report and studies on osteoporosis done in SA. Where accessible, the timeliest systematic review, meta-analysis, and randomized controlled trials were used as evidence.

Results: The present update includes new recommendations for the assessment of osteoporosis taking into consideration the Saudi model of FRAX for fracture probabilities, appropriate doses for the maintenance of vitamin D status and calcium, the use of representative blood analytes for therapy monitoring, the use of romosozumab and sequential therapy in the pharmacological management strategies, and the establishment of fracture liaison services to prevent secondary fractures.

Conclusion: This updated guideline is for all healthcare professionals involved in osteoporosis and post-fracture care and management in SA and harmonized the most up-to-date changes in the field based on evidence-based medicine for use in the local setting.

Keywords: Diagnosis; Osteoporosis; Saudi Osteoporosis Society.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Ten-year probability of a major osteoporotic fracture in Saudi women by age [12]. The solid line shows probabilities in Saudi women with no clinical risk factors; dotted line shows probabilities in women with a prior fragility fracture. BMI was set at 25 kg/m2 (modified with permission from Saleh et al. (2022) (12))
Fig. 2
Fig. 2
Categorization of fracture risk using FRAX major osteoporotic fracture probability in postmenopausal women as recommended by IOF and ESCEO [23]. Initial risk assessment uses FRAX with clinical risk factors without BMD. If FRAX probability falls in the intermediate (orange) zone, then BMD assessment is needed with recalculation of FRAX probability after including femoral neck BMD. Treatment is based on recalculated risk
Fig. 3
Fig. 3
Diagnosis and management of osteoporosis
Fig. 4
Fig. 4
Proposed sequential therapy for patients with severe osteoporosis or imminent risk of fracture, reproduced with permission [39]
See this image and copyright information in PMC

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