Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women
Authors: John J. Carey, E. Michael Lewiecki, Robert D. Blank, Chris R. Shuhart, Bjoern Buehring
Journal: Annals of Internal Medicine (2017)

Letters19 December 2017Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and WomenJohn J. Carey, MBBCh, BAO, MS, E. Michael Lewiecki, MD, Robert D. Blank, MD, Chris R. Shuhart, MD, and Bjoern Buehring, MDJohn J. Carey, MBBCh, BAO, MSNational University of Ireland Galway, Galway, Ireland (J.J.C.)Search for more papers by this author, E. Michael Lewiecki, MDNew Mexico Clinical Research & Osteoporosis Center, Albuquerque, New Mexico (E.M.L.)Search for more papers by this author, Robert D. Blank, MDUniversity of Wisconsin, Madison, Wisconsin (R.D.B., B.B.)Search for more papers by this author, Chris R. Shuhart, MDSwedish Bone Health and Osteoporosis Centre, Seattle, Washington (C.R.S.)Search for more papers by this author, and Bjoern Buehring, MDUniversity of Wisconsin, Madison, Wisconsin (R.D.B., B.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0487 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Qaseem and colleagues' updated guideline on treatment of low bone density or osteoporosis to prevent fractures in men and women with interest (1). We acknowledge the huge task that the authors have undertaken on this important topic but have major concerns about the inconsistencies in application of their methods, the data presented, and their conclusions. We are particularly concerned with recommendation 4, which “recommends against bone density monitoring during the 5-year pharmacologic treatment period for osteoporosis in women.”The authors make no mention of the scale of the problem associated with osteoporotic fractures or the ...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. 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 Scholar3. Lenchik L, Kiebzak GM, Blunt BA; International Society for Clinical Densitometry Position Development Panel and Scientific Advisory Committee. What is the role of serial bone mineral density measurements in patient management? J Clin Densitom. 2002;5 Suppl:S29-38. [PMID: 12464709] CrossrefMedlineGoogle Scholar4. Hochberg MC, Ross PD, Black D, Cummings SR, Genant HK, Nevitt MC, et al. Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group. Arthritis Rheum. 1999;42:1246-54. [PMID: 10366118] CrossrefMedlineGoogle Scholar5. Jacques RM, Boonen S, Cosman F, Reid IR, Bauer DC, Black DM, et al. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27:1627-34. [PMID: 22532515] doi:10.1002/jbmr.1644 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National University of Ireland Galway, Galway, Ireland (J.J.C.)New Mexico Clinical Research & Osteoporosis Center, Albuquerque, New Mexico (E.M.L.)University of Wisconsin, Madison, Wisconsin (R.D.B., B.B.)Swedish Bone Health and Osteoporosis Centre, Seattle, Washington (C.R.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0487. 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 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 Paul D. Miller Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women Olivier Lamy , Bérengère Aubry-Rozier , and Elena Gonzalez-Rodriguez Metrics 19 December 2017Volume 167, Issue 12Page: 901KeywordsBone densityBone mineral densityDisclosureDual energy x ray absorptiometryForecastingOsteoporosisTreatment guidelines ePublished: 19 December 2017 Issue Published: 19 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...