Osteoporosis

Many Women Not Screened or Treated for Osteoporosis Despite Guidelines

Only a small proportion of individuals at risk for osteoporosis are evaluated and treated, according to new guidelines from the American Association of Clinical Endocrinologists and American College of Endocrinology.

Despite nearly 10.2 million Americans having osteoporosis, fewer than 1 in 4 women aged 67 years or older with an osteoporosis-related fracture undergoes bone density measurement or osteoporosis treatment, according to the guidelines.
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Among the recommendations:

  • Evaluate all postmenopausal women aged 50 or older for osteoporosis risk.
  • Strongly recommend pharmacologic therapy for patients with osteopenia and a history of fragility fracture of the hip or spine.
  • Teriparatide, denosumab, or zoledronic acid should be considered for patients unable to use oral therapy and as initial therapy for patients at especially high fracture risk.
  • Successful treatment of osteoporosis is defined as stable or increasing bone mineral density with no evidence of new fractures or fracture progression
  • Treatment with teriparatide should always be followed by antiresorptive agents to prevent bone density decline and loss of fracture efficacy
  • Consider alternative therapy or reassessment for causes of secondary osteoporosis in patients who have recurrent fractures or significant bone loss while on therapy.

The guidelines call for further study into the means of communicating benefit and risk of osteoporosis management.

—Michael Potts

Reference:

Camacho PM, Petak SM, Binkley N, et al. American Association Of Clinical Endocrinologists and American College Of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis—2016. Endocrine Practice. 2016; 22(9):1111-1118.