Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women
Authors: Paul D. Miller
Journal: Annals of Internal Medicine (2017)

Letters19 December 2017Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and WomenPaul D. Miller, MDPaul D. Miller, MDColorado Center for Bone Research, Lakewood, Colorado (P.D.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0486 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As a specialist in metabolic bone disease who prescribes a large amount of anabolic agents to improve bone strength, I am concerned about Qaseem and colleagues' clinical practice guideline for women with osteoporosis (1), which focuses only on treatment with antiresorptive therapies. This guideline fails to acknowledge or address what has become a crisis in health care, with the yearly incidence of osteoporotic fractures affecting more women in the United States than stroke, heart attack, and breast cancer combined. Once a patient has had a first osteoporotic fracture, her risk for another fracture is 5 times higher, ...Reference1. Qaseem A, Forciea MA, McLean RM, Denberg TD; Clinical Guidelines Committee of the American College of Physicians. 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. 2017;166:818-39. [PMID: 28492856]. doi:10.7326/M15-1361 LinkGoogle Scholar2. Tsai JN, Uihlein AV, Lee H, Kumbhani R, Siwila-Sackman E, McKay EA, et al. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. Lancet. 2013;382:50-6. [PMID: 23683600] doi:10.1016/S0140-6736(13)60856-9 CrossrefMedlineGoogle Scholar3. Cosman F, Nieves JW, Dempster DW. Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res. 2017;32:198-202. [PMID: 27925287] doi:10.1002/jbmr.3051 CrossrefMedlineGoogle Scholar4. Camacho PM, Petak SM, Binkley N, Clarke BL, Harris ST, Hurley DL, et al. American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis–2016–executive summary. Endocr Pract. 2016;22:1111-8. [PMID: 27643923] doi:10.4158/EP161435.ESGL CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Colorado Center for Bone Research, Lakewood, Colorado (P.D.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0486. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians Amir Qaseem , Mary Ann Forciea , Robert M. McLean , Thomas D. Denberg , and Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women John J. Carey , E. Michael Lewiecki , Robert D. Blank , Chris R. Shuhart , and Bjoern Buehring Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Jean-Yves Reginster , René Rizzoli , John A. Kanis , and Cyrus Cooper Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Emily Frank Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Mary Ann Forciea , Robert M. McLean , and Amir Qaseem Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women E. Michael Lewiecki Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Susan Ott Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Toshihiro Sugiyama Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Olivier Lamy , Bérengère Aubry-Rozier , and Elena Gonzalez-Rodriguez Metrics Cited byReview of the guideline of the American College of Physicians on the treatment of osteoporosis 19 December 2017Volume 167, Issue 12Page: 903-904KeywordsBoneBone densityDisclosureForecastingHealth careMetabolic disordersMyocardial infarctionOsteoporosisStrokeTreatment guidelines ePublished: 19 December 2017 Issue Published: 19 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...