Management of osteoporosis, fracture and falls in people with multiple sclerosis: Systematic review of guidelines
Document Type
Journal Article
Publication Title
Calcified Tissue International
Publisher
Springer
School
School of Medical and Health Sciences / Nutrition and Health Innovation Research Institute
RAS ID
62083
Funders
Royal Perth Hospital Research Foundation Fellowship / Emerging Leader Fellowship fron the Future Health Research and Innovation Fund / Multiple Sclerosis Australia Fellowship
Abstract
People with multiple sclerosis (MS) have a higher prevalence of osteoporosis, falls and fractures. Guidelines for MS populations targeting the management of osteoporosis, fracture and falls risk may help reduce the burden of musculoskeletal disease in this population. We aimed to systematically review current guidelines regarding osteoporosis prevention, screening, diagnosis and management in people with MS. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic review of scientific databases (MEDLINE, CINAHL, Embase and Scopus) was performed (n = 208). In addition, websites from MS organisations and societies were screened for clinical guidelines (n = 28). Following duplicate removal, screening and exclusions (n = 230), in total six guidelines were included in this review. Three of the identified guidelines were specific to managing osteoporosis in MS, while two linked vitamin D to bone health and one was focused on the effect of acute glucocorticoid use for MS exacerbations on bone health. All guidelines were found to contain inadequate recommendations for osteoporosis screening, management and treatment in people with MS given the evidence of higher prevalence of osteoporosis at an earlier age and compounding risk factors in this population. Early diagnosis and treatment of osteoporosis in people with MS is necessary as fractures lead to significant morbidity and mortality. Development of structured clinical guidelines directed at specific healthcare services will ensure screening, appropriate management, and care of bone health in people with MS.
DOI
10.1007/s00223-023-01159-z
Access Rights
subscription content
Comments
Management of osteoporosis, fracture and falls in people with multiple sclerosis: Systematic review of guidelines. Calcified Tissue International. Advance online publication. https://doi.org/10.1007/s00223-023-01159-z