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Title: New Guidelines on Pharmacologic Treatment of Osteoporosis to Prevent Fractures in Men, Women
URL: http://www.pslgroup.com/dg/22CA0E.htm
Doctor's Guide
September 17, 2008

PHILADELPHIA -- September 17, 2008 -- The American College of Physicians (ACP) has released a new clinical practice guideline on pharmacologic treatment of osteoporosis or low bone density to prevent fracture in men and women. The guideline appears in the September 16 issue of Annals of Internal Medicine.

The ACP recommends that physicians offer drug treatment to men and women who have been diagnosed with osteoporosis or a previous fracture not caused by substantial trauma.

The guideline also recommends that doctors and their patients consider drug treatment to prevent fracture for men and women who are at risk of developing osteoporosis.

The authors did not find evidence to prove that a particular drug is better than another medication. They recommend that physicians make individual treatment decisions based on the risks, benefits, and side effects profile of available drug options.

"Because treatment options may affect various parts of skeletal system differently, we analysed the available evidence on numerous drugs to prevent fractures in men and women," said coauthor Vincenza Snow, MD, Clinical Programs and Quality of Care at ACP, Philadelphia, Pennsylvania.

"Bisphosphonates can be considered a first-line therapy, particularly for patients at risk for hip fracture. However, there is no clear evidence showing the appropriate duration of treatment with these drugs."

Among other available treatment options, the authors found that estrogen reduces the risk of vertebral, non-vertebral, and hip fractures, but can increase the risk of certain cancers, stroke, and blood clots. Studies show that drugs that work on estrogen receptors have no serious side effects and decrease spine fractures but not hip fractures.

They also found fair to good evidence that calcitonin and teriparatide reduce spine fractures but calcitonin does not reduce other types of fractures. Neither drug has serious side effects. "The evidence on use of calcium, with or without vitamin D, is mixed and the effectiveness is modest," said Dr. Snow.

The new guideline was based on a systematic evidence review of previously published studies.

SOURCE: American College of Physicians

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