ACP Issues Guidelines for Pharmacologic Treatment of Low Bone Density, Osteoporosis

The American College of Physicians has released recommendations for the pharmacologic treatment of patients with low bone density or osteoporosis.

The guidelines, published in the Annals of Internal Medicine, are based on efficacy data from more than 100 randomized, controlled trials or meta-analyses, as well as safety data from nearly 500 articles.

Among the recommendations:

• Clinicians should offer pharmacotherapy (e.g., bisphosphonates, raloxifene) to women and men who have osteoporosis or have experienced fragility fractures.

• Providers should consider treatment for adults at risk for osteoporosis, especially those who have T scores between –1.5 and –2.5, are older than age 62, or are receiving glucocorticoids.

• Clinicians should assess the potential benefits and risks of each drug option in each patient before deciding on treatment. (The Annals article includes a helpful table summarizing the benefits and harms of various treatments.)