New Osteoporosis Clinical Practice Guideline Released

Treatment recommended for all diagnosed patients; researchers urged to study more men

TUESDAY, Sept. 16 (HealthDay News) -- Among all patients with osteoporosis or a history of fragility fractures, pharmacologic treatment should be offered to reduce fracture risk, according to a new Clinical Practice Guideline published in the Sept. 16 issue of the Annals of Internal Medicine.

Amir Qaseem, M.D., Ph.D., of the American College of Physicians in Philadelphia, and colleagues from the Clinical Efficacy Assessment Subcommittee of the American College of Physicians reviewed literature published between 1966 and 2006, and selected 76 randomized controlled trials and 24 meta-analyses for their efficacy analyses, and 491 articles for their analyses of adverse events.

The authors found high-quality evidence to strongly support their recommendation that clinicians offer pharmacologic treatment to all patients with diagnosed osteoporosis or a history of fragility fractures; moderate-quality evidence to weakly support their recommendation that treatment be considered for patients who are at risk of developing osteoporosis; and moderate-quality evidence to strongly support their recommendation that pharmacologic treatment of osteoporosis be based on an assessment of individual benefits and risks. They also recommended additional research to assess the benefits and risks of osteoporosis treatments.

"Current evidence is mostly concentrated on postmenopausal women; more research on other patient populations, including men, is needed," the authors write. "Comparative effectiveness data on preventing fractures from head-to-head studies with sufficient power to detect differences would be helpful. The association between bisphosphonates and osteonecrosis of the jaw also needs to be studied. Finally, future research is needed on prevention strategies in both men and women and on the appropriate duration of treatment for osteoporosis."

The study authors report financial relationships with the pharmaceutical industry.

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