TY - JOUR T1 - Threshold based on bone mineral density for therapeutic decision-making in postmenopausal women and men over 50 years old under glucocorticoid therapy JO - Reumatología Clínica (English Edition) T2 - AU - Brance,María Lorena AU - Larroudé,María Silvia AU - Somma,Luis Fernando AU - Giacoia,Evangelina AU - Diehl,María AU - Galich,Ana María AU - Ramirez Stieben,Luis Agustín AU - Maher,María Cielo AU - De La Vega,María AU - Ringer,Ariana AU - Brun,Lucas R. SN - 21735743 M3 - 10.1016/j.reumae.2022.10.002 DO - 10.1016/j.reumae.2022.10.002 UR - https://www.reumatologiaclinica.org/en-threshold-based-on-bone-mineral-articulo-S2173574323000515 AB - Introduction and aimT-score bone mineral density (BMD) thresholds may influence guidance for treatment in patients under glucocorticoid (GC) therapy. Different BMD thresholds have been described but there is no international consensus. The aim of this study was to find a threshold to help in treatment decision-making in the population under GC therapy. MethodsA working group representing three scientific societies from Argentina was convened. The first team was formed by specialists with expertise in glucocorticoid-induced osteoporosis (GIO) who voted according to summary of evidence. The second team was constituted by a methodology group who coordinated and supervised each stage. We conducted two systematic reviews to synthesize the evidence. The first included trials of drugs used in GIO to analyze the BMD cut-off used as inclusion criteria. In the second, we analyzed the evidence regarding the densitometric thresholds to discriminate between fractured and non-fractured patients under GC treatment. ResultsIn the first review, 31 articles were included for qualitative synthesis and more than 90% of the trials included patients regardless of their densitometric T-score or range of osteopenia. In the second review, 4 articles were included and more than 80% of the T-scores were in the range −1.6 to −2.0. The summary of findings was analyzed and put to a vote. ConclusionsWith more than 80% agreement of the voting expert panel, a T-score≤−1.7 was considered the most appropriate for treatment in postmenopausal women and men over 50 years of age under GC therapy. This study could help in treatment decision-making in patients under GC therapy without fractures but other fracture risk factors should certainly be considered. ER -