Date of release: 17 October, 2016
New guidelines for risk assessment, diagnosis and treatment of postmenopausal osteoporosis
Introduction
The American Association of Clinical Endocrinologists and the American College of Endocrinology recently updated their guidelines for the diagnosis and treatment of postmenopausal osteoporosis [1]. These guidelines are presented in a very methodological way, with answers to common core questions. While the full text can be seen in the link below, I decided to pick only the recommendations which seem the most important or bring some new insights. Each statement is graded (in brackets). The article includes a clear and simple treatment algorithm as well.
Comment
I found intriguing the following recommendations, which, I guess, in many countries are not in line with local reimbursement guidelines:
One may treat mild osteopenic women (T-score above -1.0) if at high risk according to FRAX score for 10-year fracture risk. Raloxifene is advised only when the increased fracture risk relates to the spine. Denosumab is included among first-line therapies. If treated, monitoring of DXA values is advised every 1–2 years until stabilization and even later on during follow-up. Once again, estrogen is not included in the list of potential medications, despite its approved osteoporosis indication, and the huge database that support its efficacy in prevention of spine, hip and all-site fractures.Comentario
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