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After conducting a review of the recent literature, the ACP has updated its 2017 guideline on treating patients with low bone density or osteoporosis (NEJM JW Gen Med Jul 15 2017 and Ann Intern Med 2017; 166:818). This “focused update” is limited to pharmacologic therapy; it does not address other topics such as bone-density monitoring.
Bisphosphonates (i.e., alendronate and others) are recommended as first-line therapy for postmenopausal women and for men with primary osteoporosis; the recommendation is “strong” for women and “conditional” for men.
The RANK ligand inhibitor denosumab (Prolia) is recommended as second-line therapy for women or men with contr…