Change in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture Effect
Authors: Katy J.L. Bell, Andrew Hayen, Paul Glasziou, Les Irwig, Douglas C. Bauer
Journal: Annals of Internal Medicine (2017)

Letters17 January 2017Change in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture EffectKaty J.L. Bell, PhD, Andrew Hayen, PhD, Paul Glasziou, PhD, Les Irwig, PhD, and Douglas C. Bauer, MDKaty J.L. Bell, PhDFrom The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Search for more papers by this author, Andrew Hayen, PhDFrom The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Search for more papers by this author, Paul Glasziou, PhDFrom The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Search for more papers by this author, Les Irwig, PhDFrom The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Search for more papers by this author, and Douglas C. Bauer, MDFrom The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0528 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We disagree with Leslie and colleagues that their “data support the use of serial [bone mineral density (BMD)] monitoring in routine clinical practice” (1) and suggest that much of the observed association may be explained by the inclusion of fractures that occurred before the follow-up BMD testing and regression to the mean (RTM). In line with the journal's policies, we suggest that the study protocol and data set be made available to facilitate replication and reanalysis.The authors counted any incident fracture after baseline as the outcome of interest, including those that occurred before the follow-up BMD ...References1. Leslie WD, Majumdar SR, Morin SN, Lix LM. Change in bone mineral density is an indicator of treatment-related antifracture effect in routine clinical practice: a registry-based cohort study. Ann Intern Med. 2016;165:465-72. [PMID: 27428723]. doi:10.7326/M15-2937 LinkGoogle Scholar2. Cummings SR, Palermo L, Browner W, Marcus R, Wallace R, Pearson J, et al. Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean. Fracture Intervention Trial Research Group. JAMA. 2000;283:1318-21. [PMID: 10714731] CrossrefMedlineGoogle Scholar3. Cummings SR, Parfitt AM. Bone density regression to the mean and the individual patient [Letter]. J Clin Endocrinol Metab. 2001;86:4001-2. [PMID: 11502847] CrossrefMedlineGoogle Scholar4. Bell KJ, Hayen A, Macaskill P, Irwig L, Craig JC, Ensrud K, et al. Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data. BMJ. 2009;338:b2266. [PMID: 19549996] doi:10.1136/bmj.b2266 CrossrefMedlineGoogle Scholar5. Bell KJ, Hayen A, Glasziou P, Irwig L, Eastell R, Harrison SL, et al. Potential usefulness of BMD and bone turnover monitoring of zoledronic acid therapy among women with osteoporosis: secondary analysis of randomized controlled trial data. J Bone Miner Res. 2016;31:1767-73. [PMID: 27027655] doi:10.1002/jbmr.2847 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The University of Sydney, Sydney, New South Wales, Australia; University of Technology Sydney, Sydney, New South Wales, Australia; Bond University, Bond, Queensland, Australia; and University of California, San Francisco, School of Medicine, San Francisco, California.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0528. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChange in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture Effect in Routine Clinical Practice William D. Leslie , Sumit R. Majumdar , Suzanne N. Morin , and Lisa M. Lix Change in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture Effect William D. Leslie , Sumit R. Majumdar , Suzanne N. Morin , and Lisa M. Lix Metrics 17 January 2017Volume 166, Issue 2Page: 152KeywordsBone densityBone mineral densityBone resorptionConflicts of interestDisabilitiesDisclosureOsteoporosis ePublished: 17 January 2017 Issue Published: 17 January 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...