Clinician s Guide to Prevention and Treatment of Osteoporosis

Size: px
Start display at page:

Download "Clinician s Guide to Prevention and Treatment of Osteoporosis"

Transcription

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

2 outline Basic pathophysiology screening approach to diagnosis treatment monitoring secondary osteoporosis

3 Basic pathophysiology Bone mass in older adults equals the peak bone mass achieved by age determined largely by genetic factors, with contributions from nutrition, endocrine status, physical activity, and health during growth The process of bone remodeling that maintains a healthy skeleton Bone loss occurs when this balance is altered The imbalance occurs with menopause and advancing age,the loss of bone tissue leads to disordered skeletal architecture and an increase in fracture risk.

4

5 Approach to the diagnosis The diagnosis of osteoporosis is established by measurement of BMD (Bone Mineral Density ) DXA (dual energy x-ray absorptiometry) measurement of the hip and spine,peripheral skeletal sites (forearm, heel, fingers) (peripheral site : primary hyperparathyroidism, severe obesity*) vetrebral imaging Biochemical markers of bone turnover

6 dual energy x-ray absorptiometry

7 Indication for BMD testing

8 Risk factors included in WHO Fracture Risk Assessment Model

9 secondary osteoporosis

10

11

12 WHO definition osteoporosis based on BMD

13

14 Biochemical markers of bone turnover resorption markers serum C-telopeptide (CTX) and urinary N-telopeptide (NTX) formation markers serum bone-specific alkaline phosphatase (BSAP), osteocalcin (OC), and aminoterminal propeptide of type I procollagen (PINP)] best collected in the morning while patients are fasting.

15 WHO FRAX in the USA FRAX was developed to calculate the 10-year probability of a hip fracture and the 10-year probability of a major osteoporotic fracture (defined as clinical vertebral, hip, forearm, or proximal humerus fracture)

16 Fracture-Risk-Assessment-Tool- (FRAX)

17 Treatment of Osteoporosis : recommendations for all patients Adequate intake of calcium and vitamin D- 1. men age consume 1000 mg/day 2. women age 51 and older and men age 71 and older consume 1200 mg/day of calcium 3. vitamin D :recommends 800 to 1000 international units (IU)per vit D deficient may be treated with 50,000 IU once a week ( 8 12 weeks to achieve a 25(OH)D blood level of approximately 30 ng/ml ) -- ->followed by IU/day

18 Treatment of Osteoporosis : recommendations for all patients Weight-bearing exercise (in which bones and muscles work against gravity as the feet and legs bear the body s weight) includes walking, jogging, Tai Chi, stair climbing, dancing, and tennis. Muscle-strengthening exercise includes weight training and other resistive exercises, such as yoga, Pilates, and boot camp programs. Cessation of tobacco use and avoidance of excessive alcohol intake ( 2 drinks /day for women or 3 drinks a day for men )

19 FDA-approved medical therapies based on the following Vertebral fracture (clinical or asymptomatic) or hip fracture Hip DXA (femoral neck or total hip) or lumbar spine T-score 2.5 Low bone mass (osteopenia) and a US-adapted WHO 10-year probability of a hip fracture 3 % or 10-year probability of any major osteoporosisrelated fracture 20 %

20 Pharmacologic therapy Bisphosphonates Alendronate : dose prevention (5 mg daily and 35 mg weekly tablets), dose treatment (10 mg daily tablet, 70 mg weekly tablet) Ibandronate :150 mg monthly tablet and 3 mg every 3 months by intravenous injection Risedronate :prevention and treatment (5 mg daily tablet; 35 mg weekly tablet; 35 mg weekly delayed release tablet; 35 mg weekly tablet packaged with six tablets of 500 mg calcium carbonate; 75 mg tablets on two consecutive days every month; and 150 mg monthly tablet) Zoledronic acid :prevention and treatment (5 mg by intravenous infusion over at least 15 min once yearly for treatment and once every 2 years for prevention) contraindicated in patients with estimated GFR below ml/min.

21 Pharmacologic therapy Calcitonin Estrogen/hormone therapy (ET/HT):Raloxifene Parathyroid hormone: teriparatide RANKL/RANKL inhibitor: denosumab -60 mg every 6 months as a subcutaneous injection.

22 Monitoring patients Central DXA assessment of the hip or lumbar spine is the gold standard for serial assessment of BMD re-evaluation after 2 years Vertebral imaging should be repeated if there is documented height loss, new back pain, postural change, or suspicious finding on chest X-ray Biochemical markers :(biochemical marker increases after 1 3 months)

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/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

Osteoporosis. Current Trend in Osteoporosis Management for Elderly in HK- Medical Perspective. Old Definition of Osteoporosis

Osteoporosis. Current Trend in Osteoporosis Management for Elderly in HK- Medical Perspective. Old Definition of Osteoporosis Current Trend in Osteoporosis Management for Elderly in HK- Medical Perspective Dr Dicky T.K. Choy Physician Jockey Club Centre for Osteoporosis Care and Control, CUHK Osteoporosis Global public health

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

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

Prevalence of Osteoporosis 5/3/2017. Rhiannon Anderson, PA-C, FLS Linda Mitchell, PA-C, FLS, DEXA Specialist

Prevalence of Osteoporosis 5/3/2017. Rhiannon Anderson, PA-C, FLS Linda Mitchell, PA-C, FLS, DEXA Specialist Rhiannon Anderson, PA-C, FLS Linda Mitchell, PA-C, FLS, DEXA Specialist Prevalence of Osteoporosis 1.5 million fractures annually in the U.S. Overall lifetime risk for an osteoporotic fracture is about

More information

Osteoporosis: Are your bones at risk of fracturing? Rachel Wallwork, MD Internal medicine resident Massachusetts General Hospital

Osteoporosis: Are your bones at risk of fracturing? Rachel Wallwork, MD Internal medicine resident Massachusetts General Hospital Osteoporosis: Are your bones at risk of fracturing? Rachel Wallwork, MD Internal medicine resident Massachusetts General Hospital What is Osteoporosis? Osteoporosis causes bones to lose density, become

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

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

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

OSTEOPOROSIS: PREVENTION AND MANAGEMENT

OSTEOPOROSIS: PREVENTION AND MANAGEMENT OSTEOPOROSIS: OVERVIEW OSTEOPOROSIS: PREVENTION AND MANAGEMENT Judith Walsh, MD, MPH Departments of Medicine and Epidemiology and Biostatistics UCSF Definitions Key Risk factors Screening and Monitoring

More information

Osteoporosis: An Overview. Carolyn J. Crandall, MD, MS

Osteoporosis: An Overview. Carolyn J. Crandall, MD, MS Osteoporosis: An Overview Carolyn J. Crandall, MD, MS Osteoporosis: An Overview Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA Objectives Review osteoporosis

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

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

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 Health for Women: Current Research, Initiatives and Recommendations

Bone Health for Women: Current Research, Initiatives and Recommendations Page 1 BONE HEALTH FOR WOMEN: CURRENT RESEARCH, INITIATIVES AND RECOMMENDATIONS Dr. Melissa Kagarise This program has been brought to you by PharmCon PharmCon is accredited by the Accreditation Council

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

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

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

Healthy Bones: Osteoporosis Management. Laurel Short, MSN, FNP-C

Healthy Bones: Osteoporosis Management. Laurel Short, MSN, FNP-C Healthy Bones: Osteoporosis Management Laurel Short, MSN, FNP-C Disclosure I have no current affiliation or financial interest with any grantor or commercial interests that may have direct interest in

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

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

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

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 Update. Greg Summers Consultant Rheumatologist

Osteoporosis Update. Greg Summers Consultant Rheumatologist Osteoporosis Update Greg Summers Consultant Rheumatologist DEFINITION OSTEOPOROSIS is LOW BONE MASS (& micro-architectural deterioration) causing AN INCREASED RISK OF FRACTURE 23 years 82 years 23 y/o

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 F. Cosman, S. J. de Beur, M. S. LeBoff, E. M. Lewiecki, B. Tanner, S. Randall R. Lindsay Osteoporosis International With other metabolic bone

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

Osteoporosis: A Tale of 3 Task Forces!

Osteoporosis: A Tale of 3 Task Forces! Osteoporosis: A Tale of 3 Task Forces! Robert A. Adler, MD McGuire Veterans Affairs Medical Center Virginia Commonwealth University Richmond, Virginia, USA Disclosures The opinions are those of the speaker

More information

Chau Nguyen, D.O. Rheumatologist Clinical Assistant Professor of Internal Medicine at Western University of Health Sciences

Chau Nguyen, D.O. Rheumatologist Clinical Assistant Professor of Internal Medicine at Western University of Health Sciences Chau Nguyen, D.O Rheumatologist Clinical Assistant Professor of Internal Medicine at Western University of Health Sciences I do not have any relationship with the manufacturer of any commercial products

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

Assessment and Treatment of Osteoporosis Professor T.Masud

Assessment and Treatment of Osteoporosis Professor T.Masud Assessment and Treatment of Osteoporosis Professor T.Masud Nottingham University Hospitals NHS Trust University of Nottingham University of Derby University of Southern Denmark 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

Overview. Bone Biology Osteoporosis Osteomalacia Paget s Disease Cases. People Centred Positive Compassion Excellence

Overview. Bone Biology Osteoporosis Osteomalacia Paget s Disease Cases. People Centred Positive Compassion Excellence Overview Osteoporosis and Metabolic Bone Disease Dr Chandini Rao Consultant Rheumatologist Bone Biology Osteoporosis Osteomalacia Paget s Disease Cases Bone Biology Osteoporosis Increased bone remodelling

More information

DISCLAIMER DO NOT DISTRIBUTE

DISCLAIMER DO NOT DISTRIBUTE DISCLAIMER The information contained in this presentation is not intended as a substitute for professional medical advice, diagnosis, or treatment. It is provided for educational purposes only. You assume

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

Pharmacy Management Drug Policy

Pharmacy Management Drug Policy SUBJECT: - Forteo (teriparatide), Prolia (denosumab), Tymlos (abaloparatide) POLICY NUMBER: Pharmacy-35 EFFECTIVE DATE: 9/07 LAST REVIEW DATE: 9/29/2017 If the member s subscriber contract excludes coverage

More information

Kristen M. Nebel, DO PENN/ LGHP Geriatrics. Temple Family Medicine Review

Kristen M. Nebel, DO PENN/ LGHP Geriatrics. Temple Family Medicine Review Kristen M. Nebel, DO PENN/ LGHP Geriatrics 10/3/17 Temple Family Medicine Review OBJECTIVES Define Revised 2017 American College of Physician Recommendations Screening, Prevention and Treatment Application

More information

TYMLOS (abaloparatide)

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

More information

Major Recommendations Recommendations apply to postmenopausal women and men age 50 and older.

Major Recommendations Recommendations apply to postmenopausal women and men age 50 and older. Clinical Practice Guideline Effective August 2007 (Revised 10/09) This guideline is based upon the guideline developed by an expert committee of the National Osteoporosis Foundation (NOF) in collaboration

More information

Name of Policy: Zoledronic Acid (Reclast ) Injection

Name of Policy: Zoledronic Acid (Reclast ) Injection Name of Policy: Zoledronic Acid (Reclast ) Injection Policy #: 355 Latest Review Date: May 2011 Category: Pharmacy Policy Grade: Active Policy but no longer scheduled for regular literature reviews and

More information

Awareness, Diagnosis, and Management of Osteoporosis in Adults with Developmental Disabilities

Awareness, Diagnosis, and Management of Osteoporosis in Adults with Developmental Disabilities Awareness, Diagnosis, and Management of Osteoporosis in Adults with Developmental Disabilities Sunil J. Wimalawansa, MD, PhD, MBA, FACP, FRCP University Professor Professor of Medicine, Physiology & Pharmacology

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

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

Clinical Practice. Presented by: Internist, Endocrinologist

Clinical Practice. Presented by: Internist, Endocrinologist Clinical Practice Management of Osteoporosis Presented by: SaeedBehradmanesh, h MD Internist, Endocrinologist Iran, Isfahan, Feb. 2017 Definition: A disease characterized by low bone mass and microarchitectural

More information

Annual Rheumatology & Therapeutics Review for Organizations & Societies

Annual Rheumatology & Therapeutics Review for Organizations & Societies Annual Rheumatology & Therapeutics Review for Organizations & Societies Biochemical Markers of Bone Turnover: Definitions and Recommendations for Monitoring Therapy Learning Objectives for Biochemical

More information

Parathyroid Hormone Analog for Osteoporosis Prior Authorization with Quantity Limit Criteria Program Summary

Parathyroid Hormone Analog for Osteoporosis Prior Authorization with Quantity Limit Criteria Program Summary Parathyroid Hormone Analog for Osteoporosis Prior Authorization with Quantity Limit Criteria Program Summary This prior authorization program applies to Commercial, NetResults A series, NetResults F series

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

Breast Cancer and Bone Loss. One in seven women will develop breast cancer during a lifetime

Breast Cancer and Bone Loss. One in seven women will develop breast cancer during a lifetime Breast Cancer and Bone Loss One in seven women will develop breast cancer during a lifetime Causes of Bone Loss in Breast Cancer Patients Aromatase inhibitors Bil Oophorectomy Hypogonadism Steroids Chemotherapy

More information

ACP Colorado-Evidence Based Management of Osteoporosis

ACP Colorado-Evidence Based Management of Osteoporosis ACP Colorado-Evidence Based Management of Osteoporosis Micol S. Rothman, MD Associate Professor of Medicine and Radiology Clinical Director Metabolic Bone Program University of Colorado School of Medicine

More information

Forteo (teriparatide) Prior Authorization Program Summary

Forteo (teriparatide) Prior Authorization Program Summary Forteo (teriparatide) Prior Authorization Program Summary FDA APPROVED INDICATIONS DOSAGE 1 FDA Indication 1 : Forteo (teriparatide) is indicated for: the treatment of postmenopausal women with osteoporosis

More information

Updates in Osteoporosis. I have no conflicts of interest. What Would You Do? Mrs. C. What s New in Osteoporosis. Page 1

Updates in Osteoporosis. I have no conflicts of interest. What Would You Do? Mrs. C. What s New in Osteoporosis. Page 1 Updates in Osteoporosis Jeffrey A. Tice, MD Associate Professor of Medicine Division of General Internal Medicine, University of California, San Francisco I have no conflicts of interest What s New in

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

Pharmacy Management Drug Policy

Pharmacy Management Drug Policy SUBJECT: - Forteo (teriparatide), Prolia (denosumab), Tymlos (abaloparatide), Boniva injection (Ibandronate) POLICY NUMBER: Pharmacy-35 EFFECTIVE DATE: 9/07 LAST REVIEW DATE: 10/15/2018 If the member s

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

Pharmacy Management Drug Policy

Pharmacy Management Drug Policy Clinical criteria used to make utilization review decisions are based on credible scientific evidence published in peer reviewed medical literature generally recognized by the medical community. Guidelines

More information

Current and Emerging Strategies for Osteoporosis

Current and Emerging Strategies for Osteoporosis Current and Emerging Strategies for Osteoporosis I have nothing to disclose. Anne Schafer, MD Assistant Professor of Medicine Division of Endocrinology & Metabolism December 12, 2014 Outline Osteoporosis

More information

Page 1. Updates in Osteoporosis. I have no conflicts of interest. What is osteoporosis? What s New in Osteoporosis

Page 1. Updates in Osteoporosis. I have no conflicts of interest. What is osteoporosis? What s New in Osteoporosis Updates in Osteoporosis Jeffrey A. Tice, MD Professor of Medicine Division of General Internal Medicine, University of California, San Francisco I have no conflicts of interest What s New in Osteoporosis

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

8/6/2018. Glucocorticoid induced osteoporosis: overlooked and undertreated? Disclosure. Objectives. Overview

8/6/2018. Glucocorticoid induced osteoporosis: overlooked and undertreated? Disclosure. Objectives. Overview Disclosure Glucocorticoid induced osteoporosis: overlooked and undertreated? I have no financial disclosure relevant to this presentation Tasma Harindhanavudhi, MD Division of Diabetes and Endocrinology

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

Keeping old bones from breaking: The diagnosis, prevention, and treatment of osteoporosis

Keeping old bones from breaking: The diagnosis, prevention, and treatment of osteoporosis Keeping old bones from breaking: The diagnosis, prevention, and treatment of osteoporosis Balanced data about medications www.rxfacts.org Copyright 2010 by The Alosa Foundation. All rights reserved. www.rxfacts.org

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

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

Chapter 39: Exercise prescription in those with osteoporosis

Chapter 39: Exercise prescription in those with osteoporosis Chapter 39: Exercise prescription in those with osteoporosis American College of Sports Medicine. (2010). ACSM's resource manual for guidelines for exercise testing and prescription (6th ed.). New York:

More information

Updates in Osteoporosis

Updates in Osteoporosis Updates in Osteoporosis Jeffrey A. Tice, MD Associate Professor of Medicine Division of General Internal Medicine, University of California, San Francisco I have no conflicts of interest What s New in

More information

Management of Osteoporosis Clinical Practice Guideline September 2013

Management of Osteoporosis Clinical Practice Guideline September 2013 Management of Osteoporosis Clinical Practice Guideline September 2013 MedStar Health and MedStar Family Choice accept and endorse the clinical guidelines set forth by the National Osteoporosis Foundation

More information

SpongeBone Menopants*

SpongeBone Menopants* SpongeBone Menopants* Adam Fershko, MD, FACP Kettering Health Network *Postmenopausal Osteoporosis Objectives O Epidemiology O Clinical significance O Pathophysiology O Screening and Diagnosis O Treatment

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

Horizon Scanning Centre March Denosumab for glucocorticoidinduced SUMMARY NIHR HSC ID: 6329

Horizon Scanning Centre March Denosumab for glucocorticoidinduced SUMMARY NIHR HSC ID: 6329 Horizon Scanning Centre March 2014 Denosumab for glucocorticoidinduced osteoporosis SUMMARY NIHR HSC ID: 6329 This briefing is based on information available at the time of research and a limited literature

More information

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

Learning Objectives. Controversies in Osteoporosis Prevention and Management. Definition. Presenter Disclosure Information. 4 4:45 pm 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

Page 1. New Developments in Osteoporosis. What s New in Osteoporosis

Page 1. New Developments in Osteoporosis. What s New in Osteoporosis New Developments in Osteoporosis Eliseo J. Pérez-Stable MD Professor of Medicine Division of General Internal Medicine Department of Medicine July 4, 2013 Declaration of full disclosure: No conflict of

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

Dumfries and Galloway. Treatment Protocol for Osteoporosis

Dumfries and Galloway. Treatment Protocol for Osteoporosis Dumfries and Galloway Treatment Protocol for Osteoporosis DIAGNOSIS OF OSTEOPOROSIS 2 Diagnostic Criteria 2 REFERRAL CRITERIA FOR DEXA 3 TREATMENT 4 Non-Drug Therapy : for all 4 Non-Drug Therapy : in the

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

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 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

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

Osteoporosis Physician Performance Measurement Set. October 2006

Osteoporosis Physician Performance Measurement Set. October 2006 American Academy of Family Physicians/American Academy of Orthopaedic Surgeons/American Association of Clinical Endocrinologists/American College of Rheumatology/The Endocrine Society/Physician Consortium

More information

Osteoporosis in Men Professor Peter R Ebeling

Osteoporosis in Men Professor Peter R Ebeling Osteoporosis in Men MD FRACP Head, Department of Medicine, School for Clinical Sciences Monash Health Translation Precinct Monash University, Clayton, Victoria 1 MonashHealth Potential Conflicts Departmental

More information

Parathyroid Hormone Analogs

Parathyroid Hormone Analogs Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.30.36 Subject: Parathyroid Hormone Analogs Page: 1 of 6 Last Review Date: September 15, 2017 Parathyroid

More information

OSTEOPOROSIS AND WHAT TO DO AFTER A VERTEBRAL FRACTURE. Lydia Au Geriatrics Ng Teng Fong Hospital

OSTEOPOROSIS AND WHAT TO DO AFTER A VERTEBRAL FRACTURE. Lydia Au Geriatrics Ng Teng Fong Hospital OSTEOPOROSIS AND WHAT TO DO AFTER A VERTEBRAL FRACTURE Lydia Au Geriatrics Ng Teng Fong Hospital LET S START WITH WHAT YOU WANT TO KNOW AND DO WITH A VERT FRACTURE Vertebral fractures Most common (550K

More information

Pathway from Fracture or Risk Factor to Treatment

Pathway from Fracture or Risk Factor to Treatment Appendix 6A - Guidance on Diagnosis and Management of Osteoporosis Pathway from Fracture or Risk Factor to Treatment Fragility Fracture = fracture sustained from a low energy fall from standing height

More information

Focusing on the Patient: Diagnosis and Management of Osteoporosis

Focusing on the Patient: Diagnosis and Management of Osteoporosis Focusing on the Patient: Diagnosis and Management of Osteoporosis Learning Objectives After participating in this educational activity, participants should be able to: 1. Apply updated guidelines to assess

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

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

Submission to the National Institute for Clinical Excellence on

Submission to the National Institute for Clinical Excellence on Submission to the National Institute for Clinical Excellence on Strontium ranelate for the prevention of osteoporotic fractures in postmenopausal women with osteoporosis by The Society for Endocrinology

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

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective The Osteoporosis Working Group King Faisal Specialist Hospital and Research Centre Hussein Raef, a Munira Al-Bugami,

More information

This Coverage Policy applies to Individual Health Insurance Marketplace benefit plans only.

This Coverage Policy applies to Individual Health Insurance Marketplace benefit plans only. This Coverage Policy applies to Individual Health Insurance Marketplace benefit plans only. INJECTABLE OSTEOPOSIS AGENTS SUBJECT Pharmacologic Agents: Bisphosphonates: Boniva IV (ibandronate) Reclast (zoledronic

More information

Session 4: New Evidence-Based Clinical Prac ce Guidelines B: Management of Osteoporosis in Post-Menopausal Women 4:15pm - 5:15pm

Session 4: New Evidence-Based Clinical Prac ce Guidelines B: Management of Osteoporosis in Post-Menopausal Women 4:15pm - 5:15pm January 20-22, 2012 Des Moines Marrio, 700 Grand Avenue, Des Moines, IA Session 4: New Evidence-Based Clinical Prac ce Guidelines B: Management of Osteoporosis in Post-Menopausal Women 4:15pm - 5:15pm

More information

OSTEOPOROSIS, OSTEOARTHRITIS AND MUSKOSKELETAL DISEASE: A CALL FOR ACTION

OSTEOPOROSIS, OSTEOARTHRITIS AND MUSKOSKELETAL DISEASE: A CALL FOR ACTION V O L U M E 5 6 N U M B E R 2 J U N E 2 0 1 4 OSTEOPOROSIS, OSTEOARTHRITIS AND MUSKOSKELETAL DISEASE: A CALL FOR ACTION PANMINERVA MED 2014;56:97-114 J. Y., A. NEUPREZ, CH. BEAUDART, F. BUCKINX, J. SLOMIAN,

More information

Update on Osteoporosis 2016

Update on Osteoporosis 2016 WELCOME! Update on Osteoporosis 2016 Jennifer J. Kelly, D.O., F.A.C.E. Associate Professor of Medicine Division of Endocrinology, Diabetes and Metabolism Upstate Medical University Director of the Clinical

More information

Preventing and Managing Osteoporosis. Jessica Ewen, MS Exercise Physiologist Alaska Regional Hospital

Preventing and Managing Osteoporosis. Jessica Ewen, MS Exercise Physiologist Alaska Regional Hospital Preventing and Managing Osteoporosis Jessica Ewen, MS Exercise Physiologist Alaska Regional Hospital What Is Osteoporosis? Osteoporosis is a disease of the bones that occurs when: You lose too much bone

More information

Outline. Osteoporosis Definition DXA* Osteoporosis is Common. Brittle bones: Pitfalls in the evaluation and management of osteoporosis

Outline. Osteoporosis Definition DXA* Osteoporosis is Common. Brittle bones: Pitfalls in the evaluation and management of osteoporosis Brittle bones: Pitfalls in the evaluation and management of osteoporosis Sri Harsha Tella, MD CCD Department of Internal Medicine Division of Endocrinology, Diabetes and Metabolism University of South

More information

OSTEOPOROSIS MEDICINES

OSTEOPOROSIS MEDICINES Bone Basics 2010. NOF. All rights reserved. National Osteoporosis Foundation 1150 17th Street, NW, Suite 850 Washington, DC 20036 (800) 223-9994 www.nof.org OSTEOPOROSIS MEDICINES Although there is no

More information

WHAT KEEPS OUR BONES STRONG?

WHAT KEEPS OUR BONES STRONG? WHAT KEEPS OUR BONES STRONG? The role of diet and lifestyle in osteoporosis prevention Thomas Walczyk PhD, Associate Professor Food Science and Technology Programme Department of Chemistry, Faculty of

More information

Dumfries and Galloway. Treatment Protocol for Osteoporosis

Dumfries and Galloway. Treatment Protocol for Osteoporosis Dumfries and Galloway Treatment Protocol for Osteoporosis DIAGNOSIS OF OSTEOPOROSIS 2 Diagnostic Criteria 2 Multiple low trauma vertebral fractures in the absence of myeloma or metastatic disease. 2 T-score

More information

Objectives. Discuss bone health and the consequences of osteoporosis on patients medical and disability status.

Objectives. Discuss bone health and the consequences of osteoporosis on patients medical and disability status. Objectives Discuss bone health and the consequences of osteoporosis on patients medical and disability status. Discuss the pathophysiology of osteoporosis and major risk factors. Assess the major diagnostic

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