Letter to the Editor
Application of the recommendations of the Spanish Society of Rheumatology on osteoporosis in a Fracture Liaison Service unit
Aplicación de las recomendaciones de la Sociedad Española de Reumatología sobre osteoporosis en una unidad Fracture Liaison Service
Francisco Rubiño
, Soledad Ojeda, Amparo Molina, Antonio Naranjo
Corresponding author
Servicio de Reumatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
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Debate abierto" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2132 "Ancho" => 2167 "Tamanyo" => 163771 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Proposed algorithm for action in case of suspicion of giant cell arteritis (GCA).</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">High level of clinical suspicion: age >50 years old and 1) with exclusively cephalic symptoms (cephalea that commenced recently, jaw claudication or visual alterations); 2) with rheumatic polymyalgia, according to EULAR/ACR 2017 criteria; 3) with toxic syndrome or non-specific fever syndrome, once infectious causes have been ruled out and screening for neoplasia has proved negative, and 4) with ictus in vertebrobasilar territory, with no relevant cardiovascular history or findings with an atherogenic or embolic etiology after a directed study.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">GCA: giant cell arteritis; TAB: temporal artery biopsy; TAUS: temporal artery ultrasound scan; INDET: indeterminate result.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Héctor Corominas, Paula Estrada Alarcón, Patricia Moya, Dèlia Reina Sanz" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Héctor" "apellidos" => "Corominas" ] 1 => array:2 [ "nombre" => "Paula" "apellidos" => "Estrada Alarcón" ] 2 => array:2 [ "nombre" => "Patricia" "apellidos" => "Moya" ] 3 => array:2 [ "nombre" => "Dèlia Reina" "apellidos" => "Sanz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X19300609" "doi" => "10.1016/j.reuma.2019.03.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X19300609?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320300083?idApp=UINPBA00004M" "url" => "/21735743/0000001700000002/v1_202101301156/S2173574320300083/v1_202101301156/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Application of the recommendations of the Spanish Society of Rheumatology on osteoporosis in a Fracture Liaison Service unit" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "122" "paginaFinal" => "123" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Rubiño, Soledad Ojeda, Amparo Molina, Antonio Naranjo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Francisco" "apellidos" => "Rubiño" "email" => array:1 [ 0 => "frubijuarez@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Soledad" "apellidos" => "Ojeda" ] 2 => array:2 [ "nombre" => "Amparo" "apellidos" => "Molina" ] 3 => array:2 [ "nombre" => "Antonio" "apellidos" => "Naranjo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Reumatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aplicación de las recomendaciones de la Sociedad Española de Reumatología sobre osteoporosis en una unidad <span class="elsevierStyleItalic">Fracture Liaison Service</span>" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The new recommendations for osteoporosis (OP) of the Spanish Society of Rheumatology (SER) propose criteria for initiation of OP treatment including patients with fragility fracture.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Thus, it is recommended that pharmacological treatment be started in patients >50 years with fragility fracture if they present: 1) Fractures of the hip or vertebra; 2) Other fragility fractures and low bone mineral density (BMD) defined by a T-score<1 SD; 3) Patients with a high risk for hip fracture according to FRAX® with BMD ≥ 3%, and 4) Patients being treated with prednisone at a dose ≥5 mg/d. The SER recommendations were applied to a series of patients treated in a Fracture Liaison Service (FLS) unit, comparing criteria according to age, sex, and type of fracture. In cases where bone densitometry (DXA) was not available, the fracture type and FRAX® for hip fracture without DXA were considered.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A total of 2162 patients with an average age of 73 years (SD: 10 years), 1778 women (82%), were analysed. DXA results are available for 1668 patients (77%). Applying the SER recommendations, 1920 patients of the total sample (89%) met the treatment criteria; 90% of the women and 83% of the men (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Of the hip and vertebrae fractures, 100% met criteria, and 83% of forearm fractures, 85% of humerus fractures and 73% of the group of other fractures. Of the 161 patients with peripheral fractures other than hip fractures where DXA is not available, 77 (48%) had FRAX® treatment criteria.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In the analysis of criteria application by decades of age, in the decade from 50 to 60, 67% of patients with forearm fractures, 79% with humerus fractures and 60% of other fractures met treatment criteria. On the other hand, in the decade from 60 to 70, 81% of patients with forearm fractures, 78% with humerus fractures and 73% with other fractures met treatment criteria.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In relation to sex, treatment for forearm fractures was indicated in 67% of the men and 85% of the women, for humerus fractures in 82% of the men and 86% of the women, and for other fractures in 62% of the men and 75% of the women.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Previous SER recommendations on OP indicated that all low-intensity trauma fractures should be treated, regardless of BMD value.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> A study comparing different international guidelines concluded that in secondary prevention the percentage of candidates for treatment was 54%–100% in females and 26%–81% in males.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In hip fractures, the figure was 81%–100% and in forearm fractures 36%–93%.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, the new criteria for treatment of fragility fracture according to SER recommendations involve treating 89% of patients over 50 years of age, 100% of hip and vertebrae fractures, and 84% of other types of fracture. In patients in whom DXA is not available, the percentage with FRAX® treatment criteria is around 69% (100% of hip and vertebra, and 48% with other fractures).</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rubiño F, Ojeda S, Molina A, Naranjo A. Aplicación de las recomendaciones de la Sociedad Española de Reumatología sobre osteoporosis en una unidad <span class="elsevierStyleItalic">Fracture Liaison Service</span>. Reumatol Clin. 2021;17:122–123.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">BMD: Bone Mineral Density; FRAX®; Fracture Risk Assessment Tool; SER: Spanish Society of Rheumatology.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The values represent No. (%).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total number \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DXA T-score<―1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Normal DXA, hip FRAX® ≥3% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Hip FRAX® ≥3% without DXA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment indication SER 2018 recommendations \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hip \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">580 (26.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">280/301 (93.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/21 (47.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">253/275 (92.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">580 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vertebra \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">221 (10.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">144/159 (90.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/14 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50/62 (80.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">221 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Forearm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">662 (30.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">505/585 (86.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6/80 (7.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43/85 (50.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">554 (83.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Humerus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">439 (20.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">343/388 (88.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/45 (8.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27/50 (54.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">374 (85.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">260 (12.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">182/235 (77.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/52 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7/26 (26.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">191 (73.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2506352.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Total percentage of patients according to fracture type and treatment indication applying SER 2018 recommendations.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de la Sociedad Española de Reumatología sobre osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Naranjo Hernández" 1 => "P. Díaz del Campo Fontecha" 2 => "M. Aguado Acín" 3 => "L. Arboleya Rodríguez" 4 => "E. Casado Burgos" 5 => "S. Castañeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2018.09.004" "Revista" => array:2 [ "tituloSerie" => "Reumatol Clín." "fecha" => "2018" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización 2011 del consenso Sociedad Española de Reumatología de osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Pérez Edo" 1 => "A. Alonso Ruiz" 2 => "D. Roig Vilaseca" 3 => "A. García Vadillo" 4 => "N. Guañabens Gay" 5 => "P. Peris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2011.05.013" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clín." "fecha" => "2011" "volumen" => "7" "paginaInicial" => "357" "paginaFinal" => "379" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22078694" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aplicación de las guías de prevención secundaria de fractura osteoporótica y del índice FRAX en una cohorte de pacientes con fractura por fragilidad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Naranjo" 1 => "S. Ojeda-Bruno" 2 => "F. Francisco-Hernández" 3 => "C. Erausquin" 4 => "I. Rúa-Figueroa" 5 => "C. Rodríguez-Lozano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2010.06.028" "Revista" => array:5 [ "tituloSerie" => "Med Clín." "fecha" => "2011" "volumen" => "136" "paginaInicial" => "290" "paginaFinal" => "292" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001700000002/v1_202101301156/S2173574321000058/v1_202101301156/en/main.assets" "Apartado" => array:4 [ "identificador" => "8400" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001700000002/v1_202101301156/S2173574321000058/v1_202101301156/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574321000058?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 12 | 22 |
| 2024 October | 38 | 31 | 69 |
| 2024 September | 39 | 16 | 55 |
| 2024 August | 54 | 34 | 88 |
| 2024 July | 31 | 24 | 55 |
| 2024 June | 45 | 22 | 67 |
| 2024 May | 46 | 33 | 79 |
| 2024 April | 47 | 24 | 71 |
| 2024 March | 31 | 28 | 59 |
| 2024 February | 32 | 27 | 59 |
| 2024 January | 57 | 26 | 83 |
| 2023 December | 30 | 25 | 55 |
| 2023 November | 35 | 29 | 64 |
| 2023 October | 25 | 26 | 51 |
| 2023 September | 30 | 34 | 64 |
| 2023 August | 25 | 12 | 37 |
| 2023 July | 23 | 22 | 45 |
| 2023 June | 25 | 24 | 49 |
| 2023 May | 31 | 31 | 62 |
| 2023 April | 18 | 12 | 30 |
| 2023 March | 44 | 17 | 61 |
| 2023 February | 29 | 22 | 51 |
| 2023 January | 32 | 13 | 45 |
| 2022 December | 37 | 30 | 67 |
| 2022 November | 39 | 20 | 59 |
| 2022 October | 43 | 23 | 66 |
| 2022 September | 38 | 26 | 64 |
| 2022 August | 29 | 30 | 59 |
| 2022 July | 30 | 27 | 57 |
| 2022 June | 29 | 31 | 60 |
| 2022 May | 34 | 31 | 65 |
| 2022 April | 34 | 26 | 60 |
| 2022 March | 34 | 53 | 87 |
| 2022 February | 38 | 32 | 70 |
| 2022 January | 48 | 34 | 82 |
| 2021 December | 27 | 42 | 69 |
| 2021 November | 26 | 33 | 59 |
| 2021 October | 41 | 52 | 93 |
| 2021 September | 36 | 35 | 71 |
| 2021 August | 21 | 18 | 39 |
| 2021 February | 2 | 4 | 6 |
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