Managing Low Bone Density and Osteoporosis

The updated guideline recommends a 5-year course of bisphosphonate or denosumab as initial therapy.

Sponsoring Organization: American College of Physicians (ACP)

Target Audience: All clinicians

Background and Objective

For fracture prevention, decisions on whom to treat — and for how long — are not always straightforward. This guideline updates previous ACP recommendations for managing low bone density or osteoporosis to prevent fractures. Osteoporosis is defined as having sustained a fragility fracture or having a bone-mineral density (BMD) T-score ≤−2.5.

Key Recommendations

The authors make only two “strong” recommendations (based on high- or moderate-quality evidence):

Clinicians should offer a bisphosphonate (alendronate, risedronate, or zoledronic acid) or denosumab (Prolia) to women with known osteoporosis.
Clinicians should not prescribe …

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose