Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women
Authors: Olivier Lamy, Bérengère Aubry-Rozier, Elena Gonzalez-Rodriguez
Journal: Annals of Internal Medicine (2017)

Letters19 December 2017Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and WomenOlivier Lamy, MD, Bérengère Aubry-Rozier, MD, and Elena Gonzalez-Rodriguez, MD, PhDOlivier Lamy, MDUniversity Hospital, Lausanne, Switzerland (O.L., B.A., E.G.)Search for more papers by this author, Bérengère Aubry-Rozier, MDUniversity Hospital, Lausanne, Switzerland (O.L., B.A., E.G.)Search for more papers by this author, and Elena Gonzalez-Rodriguez, MD, PhDUniversity Hospital, Lausanne, Switzerland (O.L., B.A., E.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0485 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Qaseem and colleagues' clinical practice guideline on the management of osteoporosis with interest (1). Given the high prevalence of osteoporotic fractures and the availability of therapies to decrease this risk, management by primary care physicians is imperative. We agree with the authors' recommendations. Limiting the duration of treatment is necessary because of the risk–benefit ratio. Describing what must be done when treatment discontinuation is associated with severe adverse effects is equally important.Bisphosphonates and denosumab have similar benefits in preventing fractures. After bisphosphonates are discontinued, no rebound effect is observed and these benefits persist. However, ...References1. 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. Bone HG, Bolognese MA, Yuen CK, Kendler DL, Miller PD, Yang YC, et al. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2011;96:972-80. [PMID: 21289258] doi:10.1210/jc.2010-1502 CrossrefMedlineGoogle Scholar3. McClung MR, Wagman RB, Miller PD, Wang A, Lewiecki EM. Observations following discontinuation of long-term denosumab therapy. Osteoporos Int. 2017;28:1723-32. [PMID: 28144701] doi:10.1007/s00198-017-3919-1 CrossrefMedlineGoogle Scholar4. Anastasilakis AD, Polyzos SA, Makras P, Aubry-Rozier B, Kaouri S, Lamy O. Clinical features of 24 patients with rebound-associated vertebral fractures after denosumab discontinuation: systematic review and additional cases. J Bone Miner Res. 2017;32:1291-6. [PMID: 28240371] doi:10.1002/jbmr.3110 CrossrefMedlineGoogle Scholar5. Reid IR, Horne AM, Mihov B, Gamble GD. Bone loss after denosumab: only partial protection with zoledronate. Calcif Tissue Int. 2017. [PMID: 28500448] doi:10.1007/s00223-017-0288-x CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital, Lausanne, Switzerland (O.L., B.A., E.G.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0485. 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 Paul D. Miller 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 Metrics Cited byRaloxifene Has No Efficacy in Reducing the High Bone Turnover and the Risk of Spontaneous Vertebral Fractures after Denosumab Discontinuation 19 December 2017Volume 167, Issue 12Page: 900-901KeywordsBone mineral densityBone remodelingDisclosureFood and Drug AdministrationHipOsteoporosisPrimary care physiciansRisk managementSpineTreatment guidelines ePublished: 19 December 2017 Issue Published: 19 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...