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Osteoporos Int (2014) 25:23592381 DOI 10.1007/s00198-014-2794-2
POSITION PAPER
Clinicians Guide to Prevention and Treatment of Osteoporosis
F. Cosman & S. J. de Beur & M. S. LeBoff & E. M. Lewiecki &
B. Tanner & S. Randall & R. Lindsay
Received: 12 June 2014 /Accepted: 24 June 2014 /Published online: 15 August 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com
Abstract The Clinicians Guide to Prevention and Treatment of Osteoporosis was developed by an expert committee of the National Osteoporosis Foundation (NOF) in collaboration with a multispecialty council of medical experts in the field of bone health convened by NOF. Readers are urged to consult current prescribing information on any drug, device, or procedure discussed in this publication.
Keywords Diagnosis . Guide . Osteoporosis . Prevention . Treatment
Executive summary
Osteoporosis is a silent disease until it is complicated by fracturesfractures that occur following minimal trauma or, in some cases, with no trauma. Fractures are common and
place an enormous medical and personal burden on the aging individuals who suffer them and take a major economic toll on the nation. Osteoporosis can be prevented, diagnosed, and treated before fractures occur. Importantly, even after the first fracture has occurred, there are effective treatments to decrease the risk of further fractures. Prevention, detection, and treatment of osteoporosis should be a mandate of primary care providers.
Since the National Osteoporosis Foundation (NOF) first published the Guide in 1999, it has become increasingly clear that many patients are not being given appropriate information about prevention and many patients are not receiving appropriate testing to diagnose osteoporosis or establish osteoporosis risk. Most importantly, many patients who have osteoporosis-related fractures are not being diagnosed with osteoporosis and are not receiving any of the Food and Drug Administration (FDA)-approved, effective therapies.
This Guide offers concise recommendations regarding prevention, risk assessment, diagnosis, and treatment of osteoporosis in postmenopausal women and men age 50 and older. It includes indications for bone densitometry and fracture risk thresholds for intervention with pharmacologic agents. The absolute risk thresholds at which consideration of osteoporosis treatment is recommended were guided by a cost-effectiveness analysis.
Synopsis of major recommendations to the clinician
Recommendations apply to postmenopausal women and men age 50 and older.
Universal...