[The new CBO-guideline 'Osteoporosis' is a broadly supported standard for clinical practice]

The Dutch Institute for Health Care Improvement (CBO) has published new (revised) guidelines for the screening and case-finding of osteoporosis and for its prevention and treatment. During the last few years, two other guidelines have been published by the Dutch College of General Practitioners and the Dutch Health Council, respectively. The CBO guideline would seem to reflect the current views on clinical practice the best and is supported by all the relevant medical specialist communities. Screening of the general population is discouraged, whilst case-finding is recommended with selected patients. Compared to the 1999 standard of the Dutch College of General Practitioners, this new consensus offers more possibilities for the preventive treatment of patients with possible osteoporosis and the treatment of patients with the disease. In the first years after menopause, treatment with oestrogens (combined if necessary with progestagens), tibolone and selective oestrogen receptor modulators may be considered. Treatment with bisphosphonates is advised in persons who are being or will be treated with corticosteroids, postmenopausal women with one or more osteoporotic fractures, or men and women with an increased risk and a T-score below -2.5. The CBO guideline constitutes the current standard for clinical practice with regard to osteoporosis. There would appear to be no need for a revision of the other guidelines.