New Osteoporosis Guidelines: What you and your health provider need to know QUESTION & ANSWER

Size: px
Start display at page:

Download "New Osteoporosis Guidelines: What you and your health provider need to know QUESTION & ANSWER"

Transcription

1 The first of the newsletters on these Qs and As should include a refresher on the Virtual Forums what they are, how they work, etc. The fact is that less than 5% of COPN members tune in for any given Forum. Many new members will not understand what they are or how they work and with a bit of education we could bump the numbers up substantially. We should also include a reminder that it s not too late to view the Forums and then include a link to the archives. New Osteoporosis Guidelines: What you and your health provider need to know QUESTION & ANSWER Wednesday, December 1, :00 p.m. to 2:00 p.m. ET 1. I m 55 years old. I ve been taking Fosavance (70mg 5600 Vit.D/week) for about 2 years. Before that I was taking Actonel (32 mg/week) for about 5 years. I was told by the doctor that I also should take calcium. My supplement gives me about 650 mg of calcium alone other microelements. Question: Why should I take calcium if I am taking bone building drug Fosavance? In order for medications like bisphosphonates to increase bone density and reduce fractures individuals still need to have adequate calcium and vitamin D from diet and supplements. All of the studies that have shown benefit of drug therapy for osteoporosis have included calcium and vitamin D supplements. It is important to know whether the supplement contains 650 mg of elemental calcium or 650 mg of the calcium salt (e.g., calcium carbonate has 250 mg elemental calcium in each 650 mg tablet). The recommended calcium intake is for elemental calcium from all sources (diet and supplements) and should be 1200 mg per day after age 50. If your diet and supplement do not provide this dose than you may wish to increase your intake. There is no evidence that taking more than 1200 mg of elemental calcium offers any additional advantage. 2. Is there an easy and inexpensive test to measure absorption of vitamin D? Inability to absorb vitamin D is uncommon, and is usually only an issue in individuals with conditions known to interfere with digestion and absorption (bowel resection, gastrectomy, celiac disease, Crohn s disease, pancreatic disease, biliary disease). In the absence of these conditions, it can be assumed that an individual will absorb vitamin D normally.

2 3. If a person has had a bone mineral density test within the past year or two, would you suggest her physician review the risk factor based on the new system to evaluate medication need. Do physicians at this point have access to the FRAX calculator? How recent should the BMD test have been to properly use the FRAX tool? The FRAX calculator is available online ( and also available as an iphone application and on some BMD machines. The CAROC system was published in the CMAJ and does not require computer based calculations. There will be available on the Osteoporosis Canada website an APP for CAROC in the future. Either of these could be used to assess 10-year fracture risk for individuals that have had previous BMD testing. The risk assessment is most accurate when the BMD test is recent (within the last 3 years) and becomes less useful over time as BMD may have changed. It is also important to be aware that the risk calculation does not apply to individuals receiving drug therapy for osteoporosis since it will overestimate fracture risk in individuals on treatment. 4. Why is only the BMD from femoral neck used in risk calculation, and not the BMD from spine? The World Health Organization (WHO) selected the femoral neck as the reference site for osteoporosis diagnosis and fracture risk assessment based upon the large number of studies that have collected data on the femoral neck, and since this is the best site for prediction of hip fracture risk which is the fracture site responsible for the greatest cost, morbidity and mortality. The Osteoporosis Canada guidelines note that when the risk assessment is in the moderate range based upon the femoral neck (10-20% fracture risk over ten years) then the lumbar spine may be helpful in deciding which individuals require treatment. Specifically, if the lumbar spine measurement is much lower than the femoral neck measurement in a moderate risk patient then treatment would be reasonable. There is ongoing research from the WHO on how best to include the lumbar spine measurement in fracture risk assessment, and this will likely be incorporated in future versions of FRAX. 5. Could you define hip BMD? Is it total hip or femoral neck density? The WHO FRAX system and CAROC systems as used in the 2010 Osteoporosis Canada guidelines are based upon the femoral neck bone density measurement. 6. Did you consider eating disorders as a risk factor? Although eating disorders are not specifically listed as a risk factor in the 2010 Osteoporosis Canada guidelines, these often produce menstrual irregularities

3 (hypogonadism) in younger women and low body weight in older women. The guidelines include both of these as indications for BMD testing (hypogonadism prior to age 50; body weight less than 60 kg or major weight loss greater than 10 % of body weight at age 25 after age 50). 7. Does a lumbar fracture show up on a BMD or is another x-ray recommended? Most lumbar spine fractures are not detected by a BMD test even when this examines the lumbar spine. Occasionally, severe fractures can be suspected on the scan but these need X-ray confirmation. Vertebral fracture assessment (VFA) can be done with some BMD scanners and is a relatively new technique for imaging the thoracic and lumbar spine to identify fractures. The 2010 Osteoporosis Canada guidelines make recommendations on the role of VFA in fracture risk assessment and patient management. An xray of the thoracic (mid) and lumbar spine ( lower) is recommended if there has been measured height loss greater than 2 cm as this may be due to a spine fracture. 8. Many older people are still on Didrocal. Is that medication considered to be of benefit? Why, in the list of drugs, is Didrocal never included? Is it because it isn't very effective? The 2010 Osteoporosis Canada guidelines still include Didrocal (etidronate) which is still available. Many patients have been successfully treated with this medication and continue to tolerate it quite well. However it has not been shown to prevent hip fractures. It is considered a second line agent as there are newer agents which have stronger evidence of fracture prevention. Etidronate can be considered for prevention of vertebral fractures in menopausal women and long term glucocorticoid users intolerant of first line therapies. 9. Do the additional factors that warrant consideration for therapy in patients at moderate risk for fracture make these patients at high risk for fracture? The additional factors that warrant consideration for therapy in patients at moderate risk helps to identify those in whom treatment may be warranted. These individuals are at higher risk than those without additional risk factors. Some (but not all) of these individuals would fall in the high risk range (>20% 10- year fracture risk). 10. Is it helpful to have a follow up BMD tests to monitor effectiveness of treatment or is the test's value limited to helping assess osteoporosis risk and diagnosis?

4 The 2010 Osteoporosis Canada guidelines provide information in terms of BMD monitoring. This remains an area of controversy as no randomized trials have directly assessed the value of repeat BMD testing on persistence with treatment or reduction of fractures. If performed, repeat measurement of BMD should initially be performed after 1 to 3 years; the retesting interval can be increased once therapy is shown to be effective. If BMD has improved or remains unchanged, the patient is considered to have had a good response to therapy. 11. So if I tripped and fell and had a hair line fracture in my 5th metatarsal of my foot, it is not due to Osteoporosis? Fractures of the head/face, hands, ankles and feet are not usually related to osteoporosis. This would include fractures of the metatarsal. These are not included as fragility fractures in the 2010 Osteoporosis Canada guidelines. 12. Does osteoporosis or the pharmacological treatment of osteoporosis affect the healing potential of bone following a fracture? There is no evidence that current medications approved for treatment of osteoporosis adversely affect bone healing after a fracture or surgery. There has been a large clinical trial after recent hip fracture that showed pharmacologic therapy not only reduced future fractures but also mortality. 13. Why is smoking considered an increased risk factor for osteoporosis? Smoking increases the risk for osteoporosis and fracture through a number of mechanisms, and is therefore considered multifactorial. In part, these effects are through a reduction in body weight (smokers tend to be thinner) and reduced physical activity. Smoking may also further reduce the low levels of circulating estrogen in post menopausal women. Smokers with lung disease may also be treated with intermittent glucocorticoids. 14. I've read most cost effective drug with low risk are thiazide diuretics. Please comment. There is some evidence that thiazide diuretics reduce calcium loss from the kidneys which may be beneficial in terms of preserving BMD and reducing fracture risk. These medications have not been tested in randomized clinical trials for osteoporosis and fracture reduction, and therefore cannot be recommended as a treatment for osteoporosis. 15. Which is better for managing my pain, ibuprofen or aspirins? I have broken both ankles, wrist and leg in three places. I am 53 years old and do not have high blood pressure.

5 Over the counter pain medications (aspirin or ASA, ibuprophen, Tylenol or acetaminophen, etc) are equally effective for fracture related pain. Gastric upset is the major side effect of anti-inflammatories (ASA, ibuprophen), and some individuals may find that they tolerate one of these better than another

New 2010 Osteoporosis Guidelines: What you and your health provider need to know QUESTIONS&ANSWERS

New 2010 Osteoporosis Guidelines: What you and your health provider need to know QUESTIONS&ANSWERS New 2010 Osteoporosis Guidelines: What you and your health provider need to know QUESTIONS&ANSWERS Wednesday, December 1, 2010 1:00 p.m. to 2:00 p.m. ET 1. I m 55 years old. I ve been taking Fosavance

More information

Osteoporosis/Fracture Prevention

Osteoporosis/Fracture Prevention Osteoporosis/Fracture Prevention NATIONAL GUIDELINE SUMMARY This guideline was developed using an evidence-based methodology by the KP National Osteoporosis/Fracture Prevention Guideline Development Team

More information

1

1 www.osteoporosis.ca 1 2 Overview of the Presentation Osteoporosis: An Overview Bone Basics Diagnosis of Osteoporosis Drug Therapies Risk Reduction Living with Osteoporosis 3 What is Osteoporosis? Osteoporosis:

More information

Module 5 - Speaking of Bones Osteoporosis For Health Professionals: Fracture Risk Assessment. William D. Leslie, MD MSc FRCPC

Module 5 - Speaking of Bones Osteoporosis For Health Professionals: Fracture Risk Assessment. William D. Leslie, MD MSc FRCPC Module 5 - Speaking of Bones Osteoporosis For Health Professionals: Fracture Risk Assessment William D. Leslie, MD MSc FRCPC Case #1 Age 53: 3 years post-menopause Has always enjoyed excellent health with

More information

Osteoporosis - New Guidelines. Michelle Glass B.Sc. (Pharm) June 15, 2011

Osteoporosis - New Guidelines. Michelle Glass B.Sc. (Pharm) June 15, 2011 Osteoporosis - New Guidelines Michelle Glass B.Sc. (Pharm) June 15, 2011 Outline What is Osteoporosis? Who is at risk? What treatments are available? Role of the Pharmacy technician Definition of Osteoporosis

More information

What is Osteoporosis?

What is Osteoporosis? What is Osteoporosis? 2000 NIH Definition A skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Bone strength reflects the integration of

More information

Osteoporosis Clinical Guideline. Rheumatology January 2017

Osteoporosis Clinical Guideline. Rheumatology January 2017 Osteoporosis Clinical Guideline Rheumatology January 2017 Introduction Osteoporosis is a condition of low bone mass leading to an increased risk of low trauma fractures. The prevalence of osteoporosis

More information

John J. Wolf, DO Family Medicine

John J. Wolf, DO Family Medicine John J. Wolf, DO Family Medicine Objectives: 1. Review incidence & Risk of Osteoporosis 2.Review indications for testing 3.Review current pharmacologic & Non pharmacologic Tx options 4.Understand & Utilize

More information

Using the FRAX Tool. Osteoporosis Definition

Using the FRAX Tool. Osteoporosis Definition How long will your bones remain standing? Using the FRAX Tool Gary Salzman M.D. Director Banner Good Samaritan/ Hayden VAMC Internal Medicine Geriatric Fellowship Program Phoenix, Arizona Using the FRAX

More information

Osteoporosis challenges

Osteoporosis challenges Osteoporosis challenges Osteoporosis challenges Who should have a fracture risk assessment? Who to treat? Drugs, holidays and unusual adverse effects Fracture liaison service? The size of the problem 1

More information

Helpful information about bone health & osteoporosis Patient Resource

Helpful information about bone health & osteoporosis Patient Resource Helpful information about bone health & osteoporosis Patient Resource Every year In the United States, 2.5 million fractures occur due to osteoporosis. Out of these, 330,000 are hip fractures, and half

More information

Page 1

Page 1 Osteoporosis Osteoporosis is a condition characterised by weakened bones that fracture easily. After menopause many women are at risk of developing osteoporosis. Peak bone mass is usually reached during

More information

Men and Osteoporosis So you think that it can t happen to you

Men and Osteoporosis So you think that it can t happen to you Men and Osteoporosis So you think that it can t happen to you Jonathan D. Adachi MD, FRCPC Alliance for Better Bone Health Chair in Rheumatology Professor, Department of Medicine Michael G. DeGroote School

More information

nogg Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK

nogg Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK nogg NATIONAL OSTEOPOROSIS GUIDELINE GROUP Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK Produced by J Compston, A Cooper,

More information

Make your. first break. your last.

Make your. first break. your last. www.iofbonehealth.org Make your first break your last WHAT IS OSTEOPOROSIS? Osteoporosis is a disease in which bones become more fragile and weak, leading to an increased risk of fractures (broken bones).

More information

1. Thought for Today 2. How Likely Am I to Fracture a Bone? 3. Upcoming Virtual Education Forums 4. Funny Bone 5. Notices/references

1. Thought for Today 2. How Likely Am I to Fracture a Bone? 3. Upcoming Virtual Education Forums 4. Funny Bone 5. Notices/references COPING A newsletter from COPN October 29, 2010 Remember: You can live well with osteoporosis! If you have received this newsletter from the Canadian Osteoporosis Patient Network (COPN) You are a COPN member

More information

Bone density scanning and osteoporosis

Bone density scanning and osteoporosis Bone density scanning and osteoporosis What is osteoporosis? Osteoporosis occurs when the struts which make up the mesh-like structure within bones become thin causing them to become fragile and break

More information

AACE/ACE Osteoporosis Treatment Decision Tool

AACE/ACE Osteoporosis Treatment Decision Tool AACE/ACE Osteoporosis Treatment Decision Tool What is Osteoporosis? OSTEOPOROSIS is defined as reduced bone strength leading to an increased risk of fracture. Osteoporosis, or porous bones, occurs when

More information

Challenging the Current Osteoporosis Guidelines. Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA

Challenging the Current Osteoporosis Guidelines. Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA Challenging the Current Osteoporosis Guidelines Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA Whom to screen Which test How to diagnose Whom to treat Benefits

More information

My joints ache. What is the difference between osteoporosis and osteoarthritis?

My joints ache. What is the difference between osteoporosis and osteoarthritis? Osteoporosis What is osteoporosis? Osteoporosis means bones are less dense, more fragile, and at greater risk for breaking, even with small injuries. This problem often affects bones in the hip, spine,

More information

Treatments for Osteoporosis Expected Benefits, Potential Harms and Drug Holidays. Suzanne Morin MD FRCP FACP McGill University May 2014

Treatments for Osteoporosis Expected Benefits, Potential Harms and Drug Holidays. Suzanne Morin MD FRCP FACP McGill University May 2014 Treatments for Osteoporosis Expected Benefits, Potential Harms and Drug Holidays Suzanne Morin MD FRCP FACP McGill University May 2014 Learning Objectives Overview of osteoporosis management Outline efficacy

More information

Osteoporosis in Men Wendy Rosenthal PharmD. This program has been brought to you by PharmCon

Osteoporosis in Men Wendy Rosenthal PharmD. This program has been brought to you by PharmCon Osteoporosis in Men Wendy Rosenthal PharmD This program has been brought to you by PharmCon Osteoporosis in Men Speaker: Dr. Wendy Rosenthal, President of MedOutcomes, will be the presenter for this webcast.

More information

Bone Density Measurement in Women

Bone Density Measurement in Women Bone Density Measurement in Women Revised 2005 Scope This guideline defines the medical necessity of bone mineral density (BMD) measurement using dualenergy x-ray absorptiometry (DXA or DEXA), and applies

More information

Clinician s Guide to Prevention and Treatment of Osteoporosis

Clinician s Guide to Prevention and Treatment of Osteoporosis Clinician s Guide to Prevention and Treatment of Osteoporosis Published: 15 August 2014 committee of the National Osteoporosis Foundation (NOF) Tipawan khiemsontia,md outline Basic pathophysiology screening

More information

Guideline for the investigation and management of osteoporosis. for hospitals and General Practice

Guideline for the investigation and management of osteoporosis. for hospitals and General Practice Guideline for the investigation and management of osteoporosis for hospitals and General Practice Background Low bone density is an important risk factor for fracture. The aim of assessing bone density

More information

Fragile Bones and how to recognise them. Rod Hughes Consultant physician and rheumatologist St Peter s hospital Chertsey

Fragile Bones and how to recognise them. Rod Hughes Consultant physician and rheumatologist St Peter s hospital Chertsey Fragile Bones and how to recognise them Rod Hughes Consultant physician and rheumatologist St Peter s hospital Chertsey Osteoporosis Osteoporosis is a skeletal disorder characterised by compromised bone

More information

Osteoporosis. When we talk about osteoporosis, we have to be familiar with the constituents of bone and what it is formed of.

Osteoporosis. When we talk about osteoporosis, we have to be familiar with the constituents of bone and what it is formed of. Osteoporosis When we talk about osteoporosis, we have to be familiar with the constituents of bone and what it is formed of. Osteoblasts by definition are those cells present in the bone and are involved

More information

What People With Celiac Disease Need to Know About Osteoporosis

What People With Celiac Disease Need to Know About Osteoporosis What People With Celiac Disease Need to Know About Osteoporosis National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892 3676 Tel:

More information

Section 4. Scans and tests. How do I know if I have osteoporosis? Investigations for spinal fractures. Investigations after you break a bone

Section 4. Scans and tests. How do I know if I have osteoporosis? Investigations for spinal fractures. Investigations after you break a bone Section 4 Scans and tests How do I know if I have osteoporosis? Investigations for spinal fractures Investigations after you break a bone Investigations if you have risk factors Investigations for children

More information

Case Finding and Risk Assessment for Osteoporosis

Case Finding and Risk Assessment for Osteoporosis Case Finding and Risk Assessment for Osteoporosis Patient may present as a fragility fracture or risk fracture Fragility fracture age 50 Clinical risk factors aged 50 Very strong clinical risk factors

More information

Beyond the T-score: New Thinking in Osteoporosis 2

Beyond the T-score: New Thinking in Osteoporosis 2 Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/beyond-the-t-score-new-thinking-in-osteoporosis-

More information

The Bare Bones of Osteoporosis. Wendy Rosenthal, PharmD

The Bare Bones of Osteoporosis. Wendy Rosenthal, PharmD The Bare Bones of Osteoporosis Wendy Rosenthal, PharmD Definition A systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase

More information

Management of postmenopausal osteoporosis

Management of postmenopausal osteoporosis Management of postmenopausal osteoporosis Yeap SS, Hew FL, Chan SP, on behalf of the Malaysian Osteoporosis Society Committee Working Group for the Clinical Guidance on the Management of Osteoporosis,

More information

Bone Mass Measurement BONE MASS MEASUREMENT HS-042. Policy Number: HS-042. Original Effective Date: 8/25/2008

Bone Mass Measurement BONE MASS MEASUREMENT HS-042. Policy Number: HS-042. Original Effective Date: 8/25/2008 Easy Choice Health Plan, Inc. Harmony Health Plan of Illinois, Inc. Missouri Care, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. WellCare Health Insurance of Illinois,

More information

Osteoporosis. Treatment of a Silently Developing Disease

Osteoporosis. Treatment of a Silently Developing Disease Osteoporosis Treatment of a Silently Developing Disease Marc K. Drezner, MD Senior Associate Dean Emeritus Professor of Medicine Emeritus University of Wisconsin-Madison Auditorium The Forest at Duke October

More information

Objectives: What is Osteoporosis 10/8/2015. Bone Health/ Osteoporosis: BASICS OF SCREENING, INTERPRETING, AND TREATING

Objectives: What is Osteoporosis 10/8/2015. Bone Health/ Osteoporosis: BASICS OF SCREENING, INTERPRETING, AND TREATING Bone Health/ Osteoporosis: BASICS OF SCREENING, INTERPRETING, AND TREATING TIFFANY PAUL, APN, CNP, CCD Objectives: Review the diagnosis of Osteoporosis Describe the basics of a bone density exam Identify

More information

HIV and your Bones Osteopenia and Osteoporosis

HIV and your Bones Osteopenia and Osteoporosis Osteopenia and Osteoporosis Background information For reasons not yet fully understood, higher rates of bone disease are starting to be seen in people living with HIV. These bone diseases include osteopenia

More information

Osteoporosis and Lupus. Andrew Ruthberg, MD University Rheumatologists

Osteoporosis and Lupus. Andrew Ruthberg, MD University Rheumatologists Osteoporosis and Lupus Andrew Ruthberg, MD University Rheumatologists 1 Forget the medical terminology (osteoporosis, osteopenia, low bone mass, DEXA, DXA, T score etc) The bottom line is that you don

More information

Building Bone Density-Research Issues

Building Bone Density-Research Issues Building Bone Density-Research Issues Helping to Regain Bone Density QUESTION 1 What are the symptoms of Osteoporosis? Who is at risk? Symptoms Bone Fractures Osteoporosis 1,500,000 fractures a year Kyphosis

More information

Osteoporosis, Fracture Risk Assessment and Promoting Healthy Bones

Osteoporosis, Fracture Risk Assessment and Promoting Healthy Bones Osteoporosis, Fracture Risk Assessment and Promoting Healthy Bones What is osteoporosis? Osteoporosis means porous or brittle bones. Osteoporosis occurs when the solid parts of the bones weaken and lose

More information

Closing the Care Gap in Osteoporosis ICE Conference 2015

Closing the Care Gap in Osteoporosis ICE Conference 2015 Closing the Care Gap in Osteoporosis ICE Conference 2015 Pat McCarthy-Briggs RD, MHEd Thank You! What is osteoporosis? a systemic skeletal disease characterized by low bone mass and microarchitectural

More information

LOVE YOUR BONES Protect your future

LOVE YOUR BONES Protect your future www.worldosteoporosisday.org LOVE YOUR BONES Protect your future Know your risk for osteoporosis www.iofbonehealth.org Osteoporosis is a problem worldwide, and in many countries, up to one in three women

More information

CASE 1 WHY IS IT IMPORTANT TO TREAT? FACTS CONCERNS

CASE 1 WHY IS IT IMPORTANT TO TREAT? FACTS CONCERNS 4:30-5:15pm Ask the Expert: Osteoporosis SPEAKERS Silvina Levis, MD OSTEOPOROSIS - FACTS 1:3 older women and 1:5 older men will have a fragility fracture after age 50 After 3 years of treatment, depending

More information

Osteoporosis. Overview

Osteoporosis. Overview v2 Osteoporosis Overview Osteoporosis is defined as compromised bone strength that increases risk of fracture (NIH Consensus Conference, 2000). Bone strength is characterized by bone mineral density (BMD)

More information

Osteoporosis Agents Drug Class Prior Authorization Protocol

Osteoporosis Agents Drug Class Prior Authorization Protocol Osteoporosis Agents Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed through review of

More information

Fracture=Bone Attack:

Fracture=Bone Attack: Fracture=Bone Attack: Linking Hip Fractures to Osteoporosis Care Angela M. Cheung, MD, PhD, FRCPC Professor of Medicine, University of Toronto Potential Conflicts of Interests Industry Grants (to UHN)

More information

Osteoporosis is a huge taboo once you pass a certain age, but it really doesn t have to be that way. Even though it is a serious, irreversible,

Osteoporosis is a huge taboo once you pass a certain age, but it really doesn t have to be that way. Even though it is a serious, irreversible, Osteoporosis is a huge taboo once you pass a certain age, but it really doesn t have to be that way. Even though it is a serious, irreversible, medical condition, people with osteoporosis can still have

More information

Section 1. What is osteoporosis? Your bones. Bones and osteoporosis. Who is affected by osteoporosis? Consequences of osteoporosis

Section 1. What is osteoporosis? Your bones. Bones and osteoporosis. Who is affected by osteoporosis? Consequences of osteoporosis 4 Section 1 What is osteoporosis? Your bones Bones and osteoporosis Who is affected by osteoporosis? Consequences of osteoporosis Less common types of osteoporosis Other bone conditions 5 Osteoporosis

More information

Name of Policy: Boniva (Ibandronate Sodium) Infusion

Name of Policy: Boniva (Ibandronate Sodium) Infusion Name of Policy: Boniva (Ibandronate Sodium) Infusion Policy #: 266 Latest Review Date: April 2010 Category: Pharmacology Policy Grade: Active Policy but no longer scheduled for regular literature reviews

More information

MAN SHORTER CAN MAKE A HOW OSTEOPOROSIS. Ask your doctor if you have osteoporosis and if Prolia may be right for you. AND WHAT YOU CAN DO NEXT

MAN SHORTER CAN MAKE A HOW OSTEOPOROSIS. Ask your doctor if you have osteoporosis and if Prolia may be right for you. AND WHAT YOU CAN DO NEXT Ask your doctor if you have osteoporosis and if Prolia may be right for you. Prolia is a prescription medicine used to increase bone mass in men with osteoporosis who: are at high risk for fracture, meaning

More information

Osteoporosis The Silent Disease

Osteoporosis The Silent Disease Joel Johnson, Yr, Subtask, Biology ER., 7/9/5 Osteoporosis The Silent Disease What is Osteoporosis? Osteoporosis is a disease which causes bones to become brittle, which increases the risk of broken bones.

More information

Osteoporosis. Skeletal System

Osteoporosis. Skeletal System Osteoporosis Introduction Osteoporosis is a very common bone disease that causes bone to become weak. Bone weakness can lead to fractures of the spine, hip, and wrist from simple falls or even a sneeze

More information

Bone Densitometry. What is a Bone Density Scan (DXA)? What are some common uses of the procedure?

Bone Densitometry. What is a Bone Density Scan (DXA)? What are some common uses of the procedure? Scan for mobile link. Bone Densitometry What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology

More information

Summary. Background. Diagnosis

Summary. Background. Diagnosis March 2009 Management of post-menopausal osteoporosis This bulletin focuses on the pharmacological management of patients with post-menopausal osteoporosis both those with clinically evident disease (e.g.

More information

Osteoporosis/Fracture Prevention Clinician Guide SEPTEMBER 2017

Osteoporosis/Fracture Prevention Clinician Guide SEPTEMBER 2017 Kaiser Permanente National CLINICAL PRACTICE GUIDELINES Osteoporosis/Fracture Prevention Clinician Guide SEPTEMBER 2017 Introduction This Clinician Guide was developed to assist Primary Care physicians

More information

Official Positions on FRAX

Official Positions on FRAX 196 96 DEPLIANT 3,5x8,5.indd 1 2010 Official Positions on FRAX 21.03.11 11:45 Interpretation and Use of FRAX in Clinical Practice from the International Society for Clinical Densitometry and International

More information

Horizon Scanning Technology Briefing. Zoledronic Acid (Aclasta) once yearly treatment for postmenopausal. National Horizon Scanning Centre

Horizon Scanning Technology Briefing. Zoledronic Acid (Aclasta) once yearly treatment for postmenopausal. National Horizon Scanning Centre Horizon Scanning Technology Briefing National Horizon Scanning Centre Zoledronic Acid (Aclasta) once yearly treatment for postmenopausal osteoporosis December 2006 This technology summary is based on information

More information

NEW DEVELOPMENTS IN OSTEOPOROSIS: SCREENING, PREVENTION AND TREATMENT

NEW DEVELOPMENTS IN OSTEOPOROSIS: SCREENING, PREVENTION AND TREATMENT NEW DEVELOPMENTS IN OSTEOPOROSIS: SCREENING, PREVENTION AND TREATMENT Judith Walsh, MD, MPH Departments of Medicine and Epidemiology and Biostatistics UCSF OSTEOPOROSIS: OVERVIEW Definitions Risk factors

More information

[If no, skip to question 10.] Y N. 2. Does the member have a diagnosis of Paget s disease of bone? Y N. [If no, skip to question 4.

[If no, skip to question 10.] Y N. 2. Does the member have a diagnosis of Paget s disease of bone? Y N. [If no, skip to question 4. Pharmacy Prior Authorization AETA BETTER HEALTH EW JERSE (MEDICAID) Zoledronic Acid (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,

More information

3. Has bone specific alkaline phosphatase level increased OR does the member have symptoms related to active Paget s?

3. Has bone specific alkaline phosphatase level increased OR does the member have symptoms related to active Paget s? Pharmacy Prior Authorization AETA BETTER HEALTH VIRGIIA CCC PLUS and MEDALLIO/FAMIS 4.0 Zoledronic Acid (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review

More information

nice bulletin NICE provided the content for this booklet which is independent of any company or product advertised

nice bulletin NICE provided the content for this booklet which is independent of any company or product advertised nice bulletin NICE provided the content for this booklet which is independent of any company or product advertised nice bulletin Welcome In August 2012, the National Institute for Health and Clinical Excellence

More information

Use of DXA / Bone Density in the Care of Your Patients. Brenda Lee Holbert, M.D. Associate Professor Senior Staff Radiologist

Use of DXA / Bone Density in the Care of Your Patients. Brenda Lee Holbert, M.D. Associate Professor Senior Staff Radiologist Use of DXA / Bone Density in the Care of Your Patients Brenda Lee Holbert, M.D. Associate Professor Senior Staff Radiologist Important Websites Resources for Clinicians and Patients www.nof.org www.iofbonehealth.org

More information

Study of secondary causes of male osteoporosis

Study of secondary causes of male osteoporosis Study of secondary causes of male osteoporosis Suárez, S.M., Giunta J., Meneses G., Costanzo P.R., Knoblovits P. Department of Endocrinology, Metabolism and Nuclear Medicine of Hospital Italiano of Buenos

More information

OSTEOPOROSIS IN INDONESIA

OSTEOPOROSIS IN INDONESIA OSTEOPOROSIS IN INDONESIA Hana Ratnawati Faculty of Medicine Maranatha Christian University Bandung - Indonesia 5th SBA Conference 2013 1 5th SBA Conference 2013 2 INTRODUCTION Indonesia is an archipelago

More information

Teriparatide (also known as Forsteo) Rheumatology Department Patient Information Leaflet

Teriparatide (also known as Forsteo) Rheumatology Department Patient Information Leaflet Teriparatide (also known as Forsteo) Rheumatology Department Patient Information Leaflet Introduction This information leaflet is about a medicine called teriparatide (also known as Forsteo) which is used

More information

Talking to patients with osteoporosis about initiating therapy

Talking to patients with osteoporosis about initiating therapy Talking to patients with osteoporosis about initiating therapy Deborah Sellmeyer, MD Director, Johns Hopkins Metabolic Bone Center Dept of Medicine, Division of Endocrinology Disclosure DSMB member for

More information

All about. Osteoporosis

All about. Osteoporosis All about Osteoporosis What is osteoporosis? Osteoporosis literally means porous bone. It is a condition that causes bones to become thin and fragile, decreasing bone strength and making them more prone

More information

Download slides:

Download slides: Download slides: https://www.tinyurl.com/m67zcnn https://tinyurl.com/kazchbn OSTEOPOROSIS REVIEW AND UPDATE Boca Raton Regional Hospital Internal Medicine Conference 2017 Benjamin Wang, M.D., FRCPC Division

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: : assessing the risk of fragility fracture bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new

More information

DISUSE OSTEOPOROSIS IN PATIENTS WITH POLIOMYELITIS

DISUSE OSTEOPOROSIS IN PATIENTS WITH POLIOMYELITIS DISUSE OSTEOPOROSIS IN PATIENTS WITH POLIOMYELITIS Jülide Öncü,MD Istanbul Sisli Etfal Teaching Hospital julideoncu@sislietfalgov.tr Arzu On,MD; Simin Hepguler,MD Ege University Medical Faculty arzuon@ege.edu.tr

More information

New Developments in Osteoporosis: Screening, Prevention and Treatment

New Developments in Osteoporosis: Screening, Prevention and Treatment Osteoporosis: Overview New Developments in Osteoporosis: Screening, Prevention and Treatment Judith Walsh, MD, MPH Departments of Medicine and Epidemiology and Biostatistics UCSF Definitions Risk factors

More information

Catch the HEDIS Buzz!

Catch the HEDIS Buzz! Catch the HEDIS Buzz! Focus Area: Osteoporosis Management in Women Who Had a Fracture Date: October 2014 HEDIS Performance Score In 2013, Humana At Home associates did a great job of promoting Osteoporosis

More information

Osteoporosis/Fracture Prevention Clinical Practice Guidelines

Osteoporosis/Fracture Prevention Clinical Practice Guidelines NATIONAL CLINICAL PRACTICE GUIDELINES Osteoporosis/Fracture Prevention Clinical Practice Guidelines Reviewed/Approved by the National Guideline Directors September 2017 Next Review/Approval: September

More information

Adjuvant bisphosphonate

Adjuvant bisphosphonate Adjuvant bisphosphonate Information for patients from the Kent Oncology Centre This leaflet is intended to support you in making decisions about the role of bisphosphonates in your breast cancer care.

More information

Monitoring Osteoporosis Therapy

Monitoring Osteoporosis Therapy Monitoring Osteoporosis Therapy SUZANNE MORIN DEPT OF MEDICINE, DIVISION OF GENERAL INTERNAL MEDICINE, MUHC CENTRE FOR OUTCOMES RESEARCH AND EVALUATION, RI MUHC November 2017 Conflict of Interest Disclosures

More information

Bisphosphonate Step Therapy Criteria

Bisphosphonate Step Therapy Criteria ϯ ϯ ϯ A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Bisphosphonate Step Therapy Criteria Program may

More information

The NOF & NBHA Quality Improvement Registry

The NOF & NBHA Quality Improvement Registry In collaboration with CECity The NOF & NBHA Quality Improvement Registry This registry is approved by CMS as a Qualified Clinical Data Registry (QCDR) for Eligible Professionals and GPRO Practices for

More information

Understanding Osteoporosis

Understanding Osteoporosis Understanding Osteoporosis Professor Juliet E. Compston Published by Family Doctor Publications Limited in association with the British Medical Association IMPORTANT NOTICE This book is intended not as

More information

Coordinator of Post Professional Programs Texas Woman's University 1

Coordinator of Post Professional Programs Texas Woman's University 1 OSTEOPOROSIS Update 2007-2008 April 26, 2008 How much of our BMD is under our control (vs. genetics)? 1 2 Genetic effects on bone loss: longitudinal twin study (Makovey, 2007) Peak BMD is under genetic

More information

Osteoporosis: fragility fracture risk. Costing report. Implementing NICE guidance

Osteoporosis: fragility fracture risk. Costing report. Implementing NICE guidance Osteoporosis: fragility fracture risk Costing report Implementing NICE guidance August 2012 NICE clinical guideline 146 1 of 15 This costing report accompanies the clinical guideline: Osteoporosis: assessing

More information

Interpreting DEXA Scan and. the New Fracture Risk. Assessment. Algorithm

Interpreting DEXA Scan and. the New Fracture Risk. Assessment. Algorithm Interpreting DEXA Scan and the New Fracture Risk Assessment Algorithm Prof. Samir Elbadawy *Osteoporosis affect 30%-40% of women in western countries and almost 15% of men after the age of 50 years. Osteoporosis

More information

Advanced medicine conference. Monday 20 Tuesday 21 June 2016

Advanced medicine conference. Monday 20 Tuesday 21 June 2016 Advanced medicine conference Monday 20 Tuesday 21 June 2016 Osteoporosis: recent advances in risk assessment and management Juliet Compston Emeritus Professor of Bone Medicine Cambridge Biomedical Campus

More information

Summary of the risk management plan by product

Summary of the risk management plan by product Summary of the risk management plan by product 1 Elements for summary tables in the EPAR 1.1 Summary table of Safety concerns Summary of safety concerns Important identified risks Important potential risks

More information

Osteoporosis Update. Case 2. Case 1: Monday morning, 8:15

Osteoporosis Update. Case 2. Case 1: Monday morning, 8:15 Osteoporosis Update Laura E. Ryan, MD Assistant Director for Special Programs Center for Women s Health Clinical Assistant Professor of Medicine Division of Endocrinology, Diabetes and Metabolism The Ohio

More information

Oral Alendronate Vs. Three-Monthly Iv Ibandronate In The Treatment Of Postmenopausal Osteoporosis

Oral Alendronate Vs. Three-Monthly Iv Ibandronate In The Treatment Of Postmenopausal Osteoporosis Oral Alendronate Vs. Three-Monthly Iv Ibandronate In The Treatment Of Postmenopausal Osteoporosis Miriam Silverberg A. Study Purpose and Rationale More than 70% of fractures in people after the age of

More information

Learning Objectives. Controversies in Osteoporosis Prevention and Management. Etiology. Presenter Disclosure Information. Epidemiology.

Learning Objectives. Controversies in Osteoporosis Prevention and Management. Etiology. Presenter Disclosure Information. Epidemiology. 12:45 1:30pm Controversies in Osteoporosis Prevention and Management SPEAKER Carolyn Crandall, MD, MS Presenter Disclosure Information The following relationships exist related to this presentation: Carolyn

More information

Disclosures. Diagnostic Challenges in Osteoporosis: Whom To Treat 9/25/2014

Disclosures. Diagnostic Challenges in Osteoporosis: Whom To Treat 9/25/2014 Disclosures Diagnostic Challenges in Osteoporosis: Whom To Treat Ethel S. Siris, MD Columbia University Medical Center New York, NY Consultant on scientific issues for: AgNovos Amgen Eli Lilly Merck Novartis

More information

Osteoporosis after Spinal Cord Injury

Osteoporosis after Spinal Cord Injury Authors: SCIRE Community Team Reviewed by: Janice Eng, PhD, PT Last updated: Oct 11, 2017 Osteoporosis is a condition that can affect the bones after spinal cord injury (SCI). This page provides information

More information

COPING A newsletter from COPN December 23, 2010 Remember: You can live well with osteoporosis!

COPING A newsletter from COPN December 23, 2010 Remember: You can live well with osteoporosis! COPING A newsletter from COPN December 23, 2010 Remember: You can live well with osteoporosis! SEASONS GREETINGS! This issue of COPING draws to a close our series of articles on the 2010 Clinical Practice

More information

Osteoporosis. Open Access. John A. Kanis. Diseases, University of Sheffield, UK

Osteoporosis. Open Access. John A. Kanis. Diseases, University of Sheffield, UK Journal of Medical Sciences (2010); 3(3): 00-00 Review Article Osteoporosis Open Access John A. Kanis WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK incorporated into

More information

Osteoporosis Treatment Overview. Colton Larson RFUMS October 26, 2018

Osteoporosis Treatment Overview. Colton Larson RFUMS October 26, 2018 Osteoporosis Treatment Overview Colton Larson RFUMS October 26, 2018 Burden of Disease Most common bone disease 9.9 million Americans + 43.1 million Americans have low bone mineral density (BMD) Stealthy

More information

AMERICAN COLLEGE OF RHEUMATOLOGY POSITION STATEMENT. Committee on Rheumatologic Care

AMERICAN COLLEGE OF RHEUMATOLOGY POSITION STATEMENT. Committee on Rheumatologic Care AMERICAN COLLEGE OF RHEUMATOLOGY POSITION STATEMENT SUBJECT: PRESENTED BY: FOR DISTRIBUTION TO: Bone Mineral Density Measurement and the Role of Rheumatologists in the Management of Osteoporosis Committee

More information

Calcium Nephrolithiasis and Bone Health. Noah S. Schenkman, MD

Calcium Nephrolithiasis and Bone Health. Noah S. Schenkman, MD Calcium Nephrolithiasis and Bone Health Noah S. Schenkman, MD Associate Professor of Urology and Residency Program Director, University of Virginia Health System; Charlottesville, Virginia Objectives:

More information

Southern Derbyshire Shared Care Pathology Guidelines. Primary Hyperparathyroidism

Southern Derbyshire Shared Care Pathology Guidelines. Primary Hyperparathyroidism Southern Derbyshire Shared Care Pathology Guidelines Primary Hyperparathyroidism Please use this Guideline in Conjunction with the Hypercalcaemia Guideline Definition Driven by hyperfunction of one or

More information

Bone Densitometry Pathway

Bone Densitometry Pathway Bone Densitometry Pathway The goal of the Bone Densitometry pathway is to manage our diagnosed osteopenic and osteoporotic patients, educate and monitor the patient population at risk for bone density

More information

Bone Health in Celiac Disease. Partha S. Sinha MD, PhD October 29 th, 2017

Bone Health in Celiac Disease. Partha S. Sinha MD, PhD October 29 th, 2017 Bone Health in Celiac Disease Partha S. Sinha MD, PhD October 29 th, 2017 No Disclosures Objectives Recognize the mechanisms by which celiac disease can affect bone health Review what diagnostic tests

More information

Fractures: Epidemiology and Risk Factors. Osteoporosis in Men (more this afternoon) 1/5 men over age 50 will suffer osteoporotic fracture 7/16/2009

Fractures: Epidemiology and Risk Factors. Osteoporosis in Men (more this afternoon) 1/5 men over age 50 will suffer osteoporotic fracture 7/16/2009 Fractures: Epidemiology and Risk Factors Mary L. Bouxsein, PhD Department of Orthopaedic Surgery Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA Outline Fracture incidence and impact

More information

BONIVA (ibandronate sodium)

BONIVA (ibandronate sodium) BONIVA (ibandronate sodium) Non-Discrimination Statement and Multi-Language Interpreter Services information are located at the end of this document. Coverage for services, procedures, medical devices

More information

Osteoporosis. Definition

Osteoporosis. Definition Osteoporosis Definition Osteoporosis causes bones to become weak and brittle so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures

More information

COPD-Related Musculoskeletal Disease. Jessica Bon Field, MD, MS 2017 Update in Internal Medicine October 20, 2017

COPD-Related Musculoskeletal Disease. Jessica Bon Field, MD, MS 2017 Update in Internal Medicine October 20, 2017 COPD-Related Musculoskeletal Disease Jessica Bon Field, MD, MS 2017 Update in Internal Medicine October 20, 2017 A 60-year old man with COPD comes into your office for a routine office visit. He is a former

More information