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.
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.
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