Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women
Authors: Toshihiro Sugiyama
Journal: Annals of Internal Medicine (2017)

Letters19 December 2017Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and WomenToshihiro Sugiyama, MD, PhDToshihiro Sugiyama, MD, PhDSaitama Medical University, Saitama, Japan (T.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0482 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues (1) recommend that clinicians treat osteoporotic women with pharmacologic therapy for 5 years. They suggest that continuing treatment after this time may benefit some patients and be appropriate after the risks and benefits of doing so are reassessed. The primary target audience is nonexpert clinicians; therefore, I would like to refer to a natural homeostatic system in the skeleton (2–5) to avoid the misunderstanding that osteoporosis can be completely resolved.The Wolff law confirms that the mechanical environment is the major determinant of skeletal architecture; well-known examples are bone loss in the weight-bearing sites ...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. Sugiyama T. Vitamin D and calcium supplementation to prevent fractures in adults [Letter]. Ann Intern Med. 2013;159:856. [PMID: 24343396]. doi:10.7326/0003-4819-159-12-201312170-00014 LinkGoogle Scholar3. Sugiyama T, Kim YT, Oda H. Osteoporosis therapy: a novel insight from natural homeostatic system in the skeleton. Osteoporos Int. 2015;26:443-7. [PMID: 25288445] doi:10.1007/s00198-014-2923-y CrossrefMedlineGoogle Scholar4. Sugiyama T, Kono Y, Sekiguchi K, Kim YT, Oda H. Age-related fragility fracture: insights from the natural homeostatic system in the skeleton [Letter]. Arch Osteoporos. 2015;10:45. [PMID: 26628422] doi:10.1007/s11657-015-0251-2 CrossrefMedlineGoogle Scholar5. Sugiyama T, Watarai K, Oda T, Kim YT, Oda H. Exercise for the skeleton in postmenopausal women: fundamental rules of mechanical strain-related stimulus [Letter]. Osteoporos Int. 2016;27:1927-8. [PMID: 26556732] doi:10.1007/s00198-015-3407-4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Saitama Medical University, Saitama, Japan (T.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0482. 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 Susan Ott 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 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. 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McLean , and Amir Qaseem Metrics Cited byMiR-124-3p Reduces Bone Mineral Density in Postmenopausal Osteoporosis Rats Through Regulating Signal Transducer and Activator of Transcription 3 PathwayUnderstanding bone fragility: theoretical explanation to non-physician health professionalsRomosozumab Treatment for Osteoporosis: Pharmacological Stimulation of Mechanical Strain-Related Bone ModelingEffects of High‐Dose Vitamin D Supplementation on Bone FragilityLong noncoding RNA HCG18 inhibits the differentiation of human bone marrow-derived mesenchymal stem cells in osteoporosis by targeting miR-30a-5p/NOTCH1 axisLetter to the Editor: "Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial"Letter to the Editor: "Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline"Vitamin D and bone health: key involvement of physical activityLetter to the Editor: "Effects of Long-Term Denosumab on Bone Histomorphometry and Mineralization in Women With Postmenopausal Osteoporosis"A multi-organ loss of tissue phenotype in COPD: involvement of the functional muscle–bone unit 19 December 2017Volume 167, Issue 12Page: 899-900KeywordsBoneBone densityCalciumDrug therapyDual energy x ray absorptiometryExerciseOsteoporosisPhoton absorptiometrySkeletonVitamin D ePublished: 19 December 2017 Issue Published: 19 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. 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