Osteoporosis treatment guidelines by US Endocrinology groups

Created September 2016

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS — 2016--EXECUTIVE SUMMARY

Endocrine Practice: September 2016, Vol. 22, No. 9, pp. 1111-1118.

doi: http://dx.doi.org/10.4158/EP161435.ESGL

* 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013 * * *Perhaps Osteoporosis groups hide vitamin D information because they fear losing their jobs* * * 8X higher Osteoporosis risk if high level of vitamin A, vitamin D important too – Feb 2013 * 5X increase in hip fracture rates in 65 years - 1998 at the same time that levels of Vitamin D have been decreasing * Osteoporosis groups hide their synthetic vitamin D recommendations behind 40 dollar paywall – May 2015 * Osteoporosis quality of life better if more than 20 ng of vitamin D – Jan 2014 Overview Osteoporosis and vitamin D contains the following summary {include} Osteoporosis category includes the following {include} An Osteoporosis Vitamin D letter behind a $40 paywall Further major uncorrected errors in National Osteoporosis Foundation meta-analyses of calcium and vitamin D supplementation in fracture prevention

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Pauline M. Camacho, MD, FACE1; Steven M. Petak, MD, MACE, FACP, FCLM, JD2; Neil Binkley, MD3; Bart L. Clarke, MD, FACP, FACE4; Steven T. Harris, MD, FACP5; Daniel L. Hurley, MD, FACE6; Michael Kleerekoper, MBBS, MACE7; E. Michael Lewiecki, MD, FACP, FACE8; Paul D. Miller, MD9; Harmeet S. Narula, MD, FACP, FACE10; Rachel Pessah-Pollack, MD, FACE11; Vin Tangpricha, MD, PhD, FACE12; Sunil J. Wimalawansa, MD, PhD, MBA, FCCP, FACP, FRCP, DSc, FACE13; Nelson B. Watts, MD, FACP, MACE14

Questions discussed

• Q1. How is fracture risk assessed and osteoporosis diagnosed?

• Q2. When osteoporosis is diagnosed, what is an appropriate evaluation?

• Q3. What are the fundamental measures for bone health?

• Q4. Who needs pharmacologic therapy?

• Q5. What medication should be used to treat osteoporosis?

• Q6. How is treatment monitored?

• Q7. What is successful treatment of osteoporosis?

• Q8. How long should patients be treated?

• Q9. Is combination therapy better than treatment with a single agent?

• Q10. Should sequential use of therapeutic agents be considered?

• Q11. Should vertebral augmentation be considered for compression fractures?

• Q12. When should referral to a clinical endocrinologist or osteoporosis specialist be considered?

Tags: How much Osteoporosis