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

Letters19 December 2017Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and WomenE. Michael Lewiecki, MDE. Michael Lewiecki, MDNew Mexico Clinical Research & Osteoporosis Center, Albuquerque, New Mexico (E.M.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0484 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:It has been said that all guidelines are wrong, but good ones are useful. Qaseem and colleagues' update of guidelines on the treatment of low bone density or osteoporosis to prevent fractures in men and women (1) is consistent with the former but not the latter. I fear that this guideline may do more harm than good by failing to reduce, and perhaps exacerbating, the already large gap in treatment of osteoporosis (2). Despite the availability of excellent tools to diagnose this condition (such as DXA), algorithms to assess fracture risk (such as the Fracture Risk Assessment ...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. Solomon DH, Johnston SS, Boytsov NN, McMorrow D, Lane JM, Krohn KD. Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res. 2014;29:1929-37. [PMID: 24535775] doi:10.1002/jbmr.2202 CrossrefMedlineGoogle Scholar3. Khosla S, Shane E. A crisis in the treatment of osteoporosis [Editorial]. J Bone Miner Res. 2016;31:1485-7. [PMID: 27335158] doi:10.1002/jbmr.2888 CrossrefMedlineGoogle Scholar4. Lewiecki EM, Adler RA, Curtis JR, Gagel R, Saag KG, Singer AJ, et al. Hip fractures and declining DXA testing: at a breaking point? J Bone Miner Res. 2016;31 Suppl S26. Google Scholar5. Brown JP, Ferrari S, Gilchrist N, Beck Jensen JE, Pannacciulli N, Recknor C, et al. Discontinuation of denosumab and associated fracture incidence: analysis from FREEDOM and its extension. J Bone Miner Res. 2016;31 Suppl S32. Google Scholar Author, Article, and Disclosure InformationAffiliations: New Mexico Clinical Research & Osteoporosis Center, Albuquerque, New Mexico (E.M.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0484. 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 Olivier Lamy , Bérengère Aubry-Rozier , and Elena Gonzalez-Rodriguez 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 Susan Ott Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Toshihiro Sugiyama Metrics Cited byAssociation of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture RiskZoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic compression fracture in a single T12 or L1 vertebral body in postmenopausal womenReview of the guideline of the American College of Physicians on the treatment of osteoporosis 19 December 2017Volume 167, Issue 12Page: 902KeywordsBone densityDisclosureHip fracturesHypertensionMedicareOsteoporosisPatientsPrevention, policy, and public healthRisk assessmentsTreatment guidelines ePublished: 19 December 2017 Issue Published: 19 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...