Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines?
Authors: Amir Qaseem, Paul Shekelle, Douglas K. Owens
Journal: Annals of Internal Medicine (2009)

Letters17 February 2009Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines?Amir Qaseem, MD, PhD, MHA, Paul Shekelle, MD, PhD, and Douglas K. Owens, MD, MSAmir Qaseem, MD, PhD, MHAFrom American College of Physicians, Philadelphia, PA 19106; Veterans Affairs Greater Los Angeles Healthcare System and RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this author, Paul Shekelle, MD, PhDFrom American College of Physicians, Philadelphia, PA 19106; Veterans Affairs Greater Los Angeles Healthcare System and RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this author, and Douglas K. Owens, MD, MSFrom American College of Physicians, Philadelphia, PA 19106; Veterans Affairs Greater Los Angeles Healthcare System and RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-4-200902170-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Alonso-Coello and colleagues for their comments regarding the ACP's recent guideline on pharmacologic treatment of osteoporosis. The Fracture Risk Assessment Tool (FRAX) may be a useful instrument for estimating an individual patient's risk for fracture, and we noted in our guideline that physicians may use such models to help guide their decisions. However, evidence from randomized, controlled trials showing the benefits of treatment in patients who were selected on the basis of their scores from FRAX is currently lacking. Almost all trials demonstrating benefit of treatment enrolled patients on the basis of BMD-determined osteoporosis, as ...References1. Liberman UA, Weiss SR, Bröll J, Minne HW, Quan H, Bell NH, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group. N Engl J Med. 1995;333:1437-43. [PMID: 7477143] CrossrefMedlineGoogle Scholar2. Reid IR, Brown JP, Burckhardt P, Horowitz Z, Richardson P, Trechsel U, et al. Intravenous zoledronic acid in postmenopausal women with low bone mineral density. N Engl J Med. 2002;346:653-61. [PMID: 11870242] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Amir Qaseem, MD, PhD, MHA; Paul Shekelle, MD, PhD; Douglas K. Owens, MD, MSAffiliations: From American College of Physicians, Philadelphia, PA 19106; Veterans Affairs Greater Los Angeles Healthcare System and RAND, Santa Monica, CA 90401; and Stanford University, Stanford, CA 94305.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPharmacologic Treatment of Low Bone Density or Osteoporosis to Prevent Fractures: A Clinical Practice Guideline from the American College of Physicians Amir Qaseem , Vincenza Snow , Paul Shekelle , Robert Hopkins Jr. , Mary Ann Forciea , and Douglas K. Owens , for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians* Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines? Pablo Alonso-Coello , Alberto López , Laurie J. Pencille , and Victor M. Montori Metrics 17 February 2009Volume 150, Issue 4Page: 286-287KeywordsBone mineral densityClinical trial reportingConflicts of interestOsteoporosisPatientsRisk assessmentsSpineTreatment guidelinesVertebral deformitiesYoung adults ePublished: 17 February 2009 Issue Published: 17 February 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...