Osteoporosis Treatment Guidelines Issued

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The Endocrine Society has released new guidelines on the pharmacologic treatment of osteoporosis in postmenopausal women.

Among the recommendations, published in the Journal of Clinical Endocrinology & Metabolism:

• Postmenopausal women at high fracture risk, particularly patients with a recent fracture, should be treated with pharmacologic therapies. A review found that the benefits outweigh the risks.

• Bisphosphonates (i.e., alendronate, risedronate, zoledronic acid, ibandronate) are recommended as the initial treatment.

• At 3 to 5 years after starting bisphosphonates, fracture risk should be reassessed. Patients at low-to-moderate risk at this point may be considered for a bisphosphonate holiday.

• Denosumab may be considered as an alternative to bisphosphonates as the initial treatment in high-risk postmenopausal women. Fracture risk should be reassessed in 5 to 10 years.