| Osteoporosis in the News

On Monday, May 8th, the American College of Physicians (ACP) released its updated guidelines for treatment of men and women with low bone density or osteoporosis. The National Osteoporosis Foundation (NOF) applauds the ACP for recognizing the need to update its previous guidelines from 2008 and emphasizing the importance of treatment for osteoporosis and the prevention of fractures in both men and women. The NOF recognizes the benefits of this report in guiding clinicians in the treatment of osteoporosis, a condition that has seen a 50% reduction of overall therapy since the mid- 2000s.  And while we feel that the guidelines may be appropriate for many patients, especially those managed in primary care settings, there are some limitations to these guidelines particularly for patients with special circumstances.

For example, in some cases anti-osteoporosis therapy may warrant a longer duration of treatment, such as follow-on therapy after discontinuation of Denosumab, which should not be stopped abruptly due to an increased risk of fractures after it is discontinued without a follow-on therapy. Additionally, it is sometimes appropriate to modify the initial treatment or duration of treatment based on level of fracture risk. In some cases a specific choice of initial medication may be based on differences in mechanism between anabolic and anti-resorptive therapies. Finally, while the ACP guideline suggests consideration of treatment for patients with osteopenia who are at high risk for fracture, clinicians may need additional guidance on the value of DXA testing and risk scoring to identify those patients at high risk.

NOF intends to review these new guidelines thoroughly, seek further public and professional input and offer recommendations to help clarify these issues and provide guidance that can extend the scope of the ACP guidelines. The ACP guidelines are an extremely important tool in helping physicians to treat the 10 million Americans affected by osteoporosis and the millions more at risk for fracture. NOF is very eager to ensure that all guidelines provide not only clinically-relevant and accurate information, but also provide guidance for as broad a range of patients as possible so as to provide the best possible osteoporosis outcomes.