Summary of the new 2022 recommendations of the Italian Society for Osteoporosis, Mineral Metabolism and Skeletal Diseases (SIOMMMS) for the management of vitamin D deficiency

Francesco Bertoldo

Internal Medicine, Department of Medicine, University Hospital of Verona

DOI 10.30455/2611-2876-2023-2e

In light of new scientific findings, the Italian Society of Mineral Metabolism and Skeletal Diseases (SIOMMMS) believed that there was a need to revise and update its original 2011 recommendations on the definition, prevention, and treatment of vitamin D deficiency in adults using a GRADE/PICO 1 system approach 1.

In recent years, there has been a steady increase in prescriptions for 25(OH)D serum level screening and for the use of vitamin D supplements.

In 2019, AIFA (Italian Medicines Agency), in Note 96, set out to regulate the reimbursement of these prescriptions, in an attempt to curb their consumption and costs, with no appropriate grounds. A multidisciplinary task force was set up to provide clinical guidelines with the following main objectives: a) to make the management of vitamin D deficiency appropriate by improving and standardising “clinical practice”; b) to provide patients with indications for the most appropriate treatment, to be followed uniformly at national level; and finally c) to ensure an evidence-based reference for national and regional institutions and agencies. Several key points were addressed. Some of these suggested a marked change in behaviour in clinical practice, including a new definition of vitamin D status with deficiency and optimal values varying depending on the population involved. For methodological aspects related to the search for corroboration and the drafting of levels of evidence and recommendations please see the original publication.

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