Association of Bone Density Monitoring in Routine Clinical Practice With Anti-Osteoporosis Medication Use and Incident Fractures: A Matched Cohort Study

Leslie, William D.; Morin, Suzanne N; Martineau, Patrick; Bryanton, Mark; Lix, Lisa M.

doi:10.1002/jbmr.3813

Cited by 22 publications

(18 citation statements)

References 37 publications

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“…The reasons for the rejection of the 204 full-text articles have been detailed (Figure 1). One-hundred-fifteen articles [6,134,143,[233][234][235][236][237][238][239][240][241][242]144,[243][244][245][246][247][145][146][147][148][149][150][151][152]135,[153][154][155][156][157][158][159][160][161][162]136,[163][164][165][166][167][168][169][170][171][172]…”

Section: Resultsmentioning

confidence: 99%

“…Antiresorptive treatment (bisphosphonates and denosumab) should be considered in patients at high risk [196,197]. SERM may be considered in postmenopausal women ≤65 years of age with One MA [23], 14 guidelines [1,110,[129][130][131]133,111,114,117,118,121,[126][127][128], and 14 articles by manual search [140,142,206,215,232,156,157,[164][165][166]185,200,205] contained relevant information for this PICO question. Because of the lack of unified goals of treatments in the existing guidelines, the goals of treatment ("a successful treatment in osteoporosis") were defined according to the European guidance [1]: no incidence of new fragility fractures, stable or increasing BMD, and achieving the reference target for BTM, which is the least significant change showing treatment efficacy [164][165][166].…”

Section: Different Type Of Dietsmentioning

confidence: 99%

“…The American Association of Clinical Endocrinologists [126] and American College of Endocrinology guidelines [111] do not require any improvement in BMD and consider a stable BMD during monitoring an appropriate target. Observational studies suggest that BMD monitoring might be associated with greater compliance, switching to more potent medications (e.g., oral to parenteral route) [215] and a reduced fracture risk [156]. However, no randomized trials have compared different follow-up strategies.…”

Section: Monitoring Of Treatment With Bmd Measured By Dxamentioning

confidence: 99%

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The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women

et al. 2020

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Section: Resultsmentioning

confidence: 99%

Section: Different Type Of Dietsmentioning

confidence: 99%

Section: Monitoring Of Treatment With Bmd Measured By Dxamentioning

confidence: 99%

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The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women

et al. 2020

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“…For antiresorptive therapies, a reduction of 50% in BTMs is typically seen in a compliant patient (50). Compliance can be enhanced when patients are aware of their response through demonstrated measures of responsivity, such as BTMs and BMD (63).…”

Section: Response To Therapymentioning

confidence: 99%

Bone Mineral Density: Clinical Relevance and Quantitative Assessment

et al. 2020

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the benefits and limitations of evaluating bone mineral density by dual-energy x-ray absorptiometry and FRAX to assess fracture risk; (2) the uses of various pharmacologic therapies available for the treatment of osteoporosis; and (3) the process of monitoring and ensuring patient response to osteoporosis therapy.Financial Disclosure: Dr. Farooki has received consulting fees from Amgen and has been an Amgen advisory board member. Dr. Bilezikian has received consulting fees from Radius and Amgen. This work was supported in part by NIH/NCI Memorial Sloan Kettering Cancer Center support grant P30 CA008748. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through April 2024.Bone mineral density (BMD) measurement by dual-energy x-ray absorptiometry (DXA) is an internationally accepted standard-of-care screening tool used to assess fragility-fracture risk. Society guidelines have recommended which populations may benefit from DXA screening and the use of the fracture risk assessment tool (FRAX) to guide decisions regarding pharmacologic treatment for osteoporosis. According to the U.S. National Osteoporosis Foundation guidelines, postmenopausal women and men at least 50 y old with osteopenic BMD warrant pharmacologic treatment if they have a FRAX-calculated 10-y probability of at least 3% for hip fracture or at least 20% for major osteoporotic fracture. Patients with osteoporosis defined by a clinical event, namely a fragility fracture, or with an osteoporotic BMD should also be treated. Patients who are treated for osteoporosis should be monitored regularly to track expected gains in BMD by serial DXA scans. With some drug therapies, BMD targets can be reached whereby further improvements in BMD are not associated with further reductions in fracture risk. Although reaching this target might suggest a stopping point for therapy, the reversibility of most treatments for osteoporosis, except for the bisphosphonates, has dampened enthusiasm for this approach. In the case of denosumab, it is now apparent that stopping therapy at any point can lead to an increase in multiplefracture risk. For patients who do not respond to antiosteoporosis pharmacologic therapy with an improvement in BMD, or who have an incident fragility fracture on therapy, secondary causes of osteoporosis or non-compliance with medical therapy should be consider...

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“…Treatment strategies of osteoporosis include non-pharmacological treatment -diet rich of calcium and vitamin D, healthy lifestyle, proper exercise plan, and pharmacological therapy [154]. BMD monitoring after initiating anti-osteoporosis therapy in the routine clinical practice setting [155].…”

Section: Osteoporosismentioning

confidence: 99%

Clinical Pharmacists in Chronic Care

Mohiuddin¹

2019

GJMR

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Pharmacy practice has changed significantly lately. The professionals have the chance to contribute straightforwardly to patient consideration so as to lessen morbimortality identified with medication use, promoting wellbeing and preventing diseases. Healthcare organizations worldwide are under substantial pressure from increasing patient demand. Unfortunately, a cure is not always possible particularly in this era of chronic complications, and the role of physicians has become limited to controlling and palliating symptoms.The increasing population of patients with longterm conditions are associated with high levels of morbidity, healthcare costs and GP workloads. Clinical pharmacy took over an aspect of medical care that had been partially abandoned by physicians. Overburdened by patient loads and the explosion of new drugs, physicians turned to pharmacists more and more for drug information, especially within institutional settings. Once relegated to counting and pouring, pharmacists headed institutional reviews of drug utilization and served as consultants to all types of health-care facilities. In addition, when clinical pharmacists are active members of the care team, they enhance proficiency by: Providing critical input on medicine use and dosing. Working with patients to solve problems with their medications and improve compliance.

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Association of Bone Density Monitoring in Routine Clinical Practice With Anti-Osteoporosis Medication Use and Incident Fractures: A Matched Cohort Study

Cited by 22 publications

References 37 publications

The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women

The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women

Bone Mineral Density: Clinical Relevance and Quantitative Assessment

Clinical Pharmacists in Chronic Care

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