Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

ACP Updates Osteoporosis Guideline

Ann Intern Med; ePub 2017 May 9; Qaseem, et al

The American College of Physicians (ACP) has updated its guideline on treating low bone density and osteoporosis to prevent fractures in men and women. In its first update since 2008, ACP strongly recommends offering pharmacologic treatment with alendronate, risedronate, zoledronic acid, or denosumab in women with osteoporosis. It also strongly recommends against using menopausal estrogen therapy or menopausal estrogen plus progestogen therapy or raloxifene to treat osteoporosis.

Other recommendations, which ACP considered weak:

  • Treat osteoporotic women with pharmacologic therapy for 5 years.
  • Offer pharmacologic treatment with bisphosphonates in men with osteoporosis.
  • It is not necessary to monitor bone density monitoring during pharmacologic treatment.
  • Make the decision whether to treat osteopenic women ≥65 years of age who are at a high risk for fracture based on patient preferences; fracture risk profile; and benefits, harms, and medication costs.

Citation:

Qaseem A, Forciea M, McLean R, Denberg. Treatment of low bone density or osteoporosis to prevent fractures in men and women: A clinical practice guideline update from the American College of Physicians. Ann Intern Med. [Published online ahead of print May 9, 2017]. doi:10.7326/M15-1361.

This Week's Must Reads

Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0

BP Treatment Assessed Among Persons with Diabetes, Diabetes Care; ePub 2018 Aug 27; Muntner, et al

Attendance Is Key in Weight Loss Management Program, Obesity; ePub 2018 Aug 29; Kumanyika, et al

Very Low LDL-C Linked with Type 2 Diabetes, PLoS Med; ePub 2018 Aug 28; Feng, et al

Abdominal Muscle Composition, Diabetes Link Studied, Diabetes Obes Metab; ePub 2018 Aug 29; Granados, et al

Must Reads in Clinical Guidelines

Guideline on Postoperative Hypoparathyroidism, Thyroid; ePub 2018 Jun 29; Orloff, Wiseman, et al

Clinical Guideline Update for Testosterone Therapy , J Clin Endocrinol Metab; ePub 2018 Mar 17; Bhasin, et al

Weight-Loss Efforts in Endometrial Ca Survivors, Cochrane; 2018 Feb 1; Kitson, Ryan, et al

Cochrane on Weight Programs and School Performance , Cochrane; 2018 Jan 29; Martin, Booth, Laird, et al