Managing Osteoporosis: Screening, Treatment, and More
|
|
- Julie Russell
- 6 years ago
- Views:
Transcription
1 This Clinical Resource gives subscribers additional insight related to the Recommendations published in July 2017 ~ Resource # Managing Osteoporosis: Screening, Treatment, and More Osteoporosis is characterized by low bone mineral density and destruction of bone tissue leading to an increased risk for fractures. 23 The bones most commonly affected by osteoporosis include the hip, spine, and wrist. 23 Osteoporosis affects millions of people worldwide, with over 50 million men and women in the U.S. having osteoporosis or low bone mineral density. 23 About one out of every two people in the U.S. older than 50 years are at risk for an osteoporotic fracture. 23 The charts below provide an overview of risk factors, guidance on who should receive screening tests, and information about medications to treat osteoporosis. Screening and Treatment Candidates Certain patients are at an increased risk of osteoporosis. It is important to identify high-risk patients in order to appropriately screen for, diagnose, and treat osteoporosis. The chart below provides guidance on which patients should be screened for and offered treatment for osteoporosis. Abbreviations: BMD = bone mineral density; DXA = Dual-energy x-ray absorptiometry Clinical Question When should a DXA or BMD study be offered? Continued Suggested Approach Pertinent Information Recommend a DXA to check BMD and screen for osteoporosis in the following patients at high risk: 4,15 Men or women with a history of low-trauma fracture Men age 70 and older Men age 50 to 69 with risk factors (see risk factors below) Women age 65 and older Postmenopausal women under age 65, especially women: o Who went through natural or surgical menopause before age 45 o Who are thin, smoke, or have a family history of fracture o With a fracture risk of 9.3% or greater per the Fracture Risk Assessment Tool (FRAX, [available at: Other patients may also be good candidates for a DXA screening, especially those with multiple risk factors. 4 Examples of risk factors include: 4 o Alcoholism o Chronic meds that may increase fracture risk (e.g., glucocorticoids, leuprolide, aromatase inhibitors) o Immobility/Inactivity
2 (Clinical Resource #330702: Page 2 of 10) Clinical Question Screening for osteoporosis, continued Suggested Approach Pertinent Information o Lifetime low calcium intake o Organ transplant o Poor health o Radiographic osteopenia (DXA T-score between -1 and -2.5) o Repeated falls o Vertebral deformity o Vision impairment Some experts believe it is not necessary to check a DXA in patients currently receiving osteoporosis treatment. 23 Women receiving osteoporosis treatment may have reduced fractures regardless of impact on BMD. 23 There is no evidence to support monitoring BMD in men receiving osteoporosis treatment. 23 Others recommend continuing to check a DXA during treatment until BMD has stabilized. 28 Check a DXA every two to three years after osteoporosis meds are stopped (three to five years after bisphosphonates [Canadian guidelines]. 28,32,40 Indications for checking DXA more frequently may include a new fracture or starting a long-term corticosteroid (i.e., >2.5 mg/day for three or more months). 32,39 Consider restarting an osteoporosis medication if: 32 o DXA T-score drops to -2.5 or below (i.e., osteoporosis). o New risk factors develop (e.g., a new fracture, starting long-term corticosteroid). 39 Who should be offered treatment for osteoporosis? Postmenopausal women, and men age 50 and older, with a T-score of -2.5 or lower (i.e., osteoporosis). 2,15,28 Postmenopausal women, and men age 50 and older, with a previous hip or spine facture. 2,15 Patients with a T-score between -1 and -2.5 (i.e., osteopenia) with the following risks per the FRAX tool: 2,28 o 10-year hip fracture risk of 3% or higher o 10-year risk of major osteoporotic fracture of 20% or higher Consider treatment for patients with low-trauma or fragility fracture. 2,4,23 Continue to the next section for a review of Medications for Osteoporosis
3 (Clinical Resource #330702: Page 3 of 10) Medications for Osteoporosis There are many considerations when selecting a medication to prevent or treat osteoporosis. Ensure all patients get adequate calcium and vitamin D. Though many women take estrogen during menopause, especially those that experience menopause prematurely, estrogen is not indicated solely for prevention or treatment of osteoporosis. 4 Treating 10,000 women 50 to 79 years of age with estrogen/progestin for one year prevents six spine and six hip fractures. However, there will be eight more cases of breast cancer, nine more strokes, and 21 more thromboembolic events [Evidence level B; lower quality RCT]. 13 For patients with low fracture risk, adequate calcium and vitamin D, and estrogen if appropriate, may be all that is needed for osteoporosis prevention. 2,4 Use the chart below to help individualize pharmacotherapy choice based on efficacy, safety, cost, and convenience. All numbers needed to treat (NNT) are in comparison to placebo. These medications haven t been directly compared. Abbreviations: GI = gastrointestinal; RANKL = receptor activator of nuclear factor kappa-b ligand; SERM = selective estrogen receptor modifier Class/Cost f (Medication[s]) Oral Bisphosphonates (alendronate [Binosto (U.S.), Fosamax, generics, etc], ibandronate [Boniva (U.S.), generics], risedronate [Actonel, Atelvia (U.S.), Actonel DR (Canada), generics, etc]) (Examples of annual costs for some generic bisphosphonates [weekly dosing]: Alendronate: ~$100 [U.S.]; ~$115 [Canada] Risedronate: ~$1,330 [U.S.]; ~$140 [Canada]) NNT to prevent one fracture over 3 yrs c Consider for Avoid in patients Comments Vertebral fracture: 1 Alendronate: 15 (16 over 2 years for men 21 ) Ibandronate: 21 Risedronate: 20 Hip fracture: 1 Alendronate: 91 Risedronate: 91 Most patients first-line 2,3 Prevention of postmenopausal osteoporosis or corticosteroid-induced osteoporosis 4,39 Treatment of postmenopausal osteoporosis, corticosteroid-induced osteoporosis, or osteoporosis in men 4,23,39 Who cannot remain upright for at least 30 minutes 2 With esophageal or swallowing disorder 2 Unable or unwilling to follow dosing instructions 2 With hypocalcemia 2 With renal insufficiency (e.g., CrCl <30 ml/min) 2,4 Dosing options: daily, weekly, or monthly (see footnote a for exceptions) GI side effects: esophagitis, dysphagia, abdominal pain, diarrhea, upset stomach, heartburn 2,4 May cause musculoskeletal pain 4 Associated rarely with jaw osteonecrosis and atypical thigh fracture 4,32 o Jaw osteonecrosis may occur in up to 0.04% of patients treated with oral bisphosphonates 25 Consider stopping after 5 years [Evidence level C; expert opinion] 23 Consider longer therapy if high-risk (e.g., femoral neck T-score <-2.5 or previous vertebral fracture and femoral neck T-score -2 or lower) 7,23,28,29,32 Doses may be safely held during hospital admissions as drug accumulates in bone and activity continues even after discontinuation 34
4 (Clinical Resource #330702: Page 4 of 10) Class/Cost f (Medication[s]) Intravenous (IV) Bisphosphonates (zoledronic acid [Reclast, Aclasta (Canada)], ibandronate [Boniva; U.S.]) (Example of annual cost for zoledronic acid: ~$300 [U.S.]; ~$360 [Canada]) NNT to prevent one fracture over 3 yrs c Consider for Avoid in patients Comments Vertebral fracture: 1 14 Patient unable to take With hypocalcemia 2 Zoledronic acid: once a year for oral bisphosphonates With renal treatment, once every 2 years for Hip fracture: 1 91 due to gastrointestinal insufficiency (e.g., prevention (single dose for prevention in (zoledronic acid only) issues 2,23,28 CrCl <30 ml/min) 2 Canada) 10,11 Patient unwilling to Ibandronate given once every 3 months follow oral for treatment (postmenopausal women) 20 bisphosphonate dosing Associated rarely with jaw osteonecrosis instructions 2,23,28 and atypical thigh fracture 4,32 When adherence is a o Osteonecrosis may occur in up to 12% concern with oral of patients treated with IV bisphosphonates 23,28 bisphosphonates 25 Patient with Consider stopping after 3 to 5 years corticosteroid-induced [Evidence level C; expert opinion]. 7,23,28 osteoporosis who is not May continue for up to 6 years if high appropriate for oral risk (e.g., femoral neck T-score bisphosphonates 39 <-2.5 or previous vertebral fracture and femoral neck T-score -2 or lower). 7,23,28,29,33 Acute renal failure reported 2 Acute flu-like reaction 4,20 May cause musculoskeletal pain 4,20 Doses may be safely held during hospital admissions. Drug accumulates in bone and activity continues even after discontinuation 34
5 (Clinical Resource #330702: Page 5 of 10) Class/Cost f (Medication[s]) Conjugated estrogen/serm Conjugated estrogen/bazedoxifene (Duavee [U.S.], Duavive [Canada]) (~$1,900 per year U.S.; ~$1,200 per year Canada) SERM Raloxifene (Evista, generics) (~$1,200 per year U.S.; ~$180 per year Canada) NNT to prevent one fracture over 3 yrs c Consider for Avoid in patients Comments No primary outcome fracture data available from randomized controlled trials 23 Vertebral fracture: (16 to 46; NNT decreases as risk increases) Prevention of postmenopausal osteoporosis in women less than 75 years old, especially in women who also require treatment for vasomotor menopausal symptoms 24 Prevention and treatment in: 2 postmenopausal women at high risk of breast cancer 2 postmenopausal women who cannot use a bisphosphonate 2 women in their 50s or 60s with concerns about long-term bisphosphonate safety. 2,19 postmenopausal women at high risk of breast cancer when hip fracture risk is not significant 28 postmenopausal women with corticosteroidinduced osteoporosis unable to take oral/iv bisphosphonates, parathyroid hormone analogs, or denosumab 39 With known or history of breast cancer or thromboembolism 24,35 With hepatic or renal impairment 24,35 With a deficiency of protein C, S, or antithrombin 24,35 With hot flashes 2 With history of venous thromboembolism 2 In whom hip fracture is the primary concern Do not take with a progestin, additional estrogen, or an additional SERM 24,35 Canadian Duavive not currently approved for an osteoporosis indication 35 Doses may be held during admissions due to increased risk of thromboembolism associated with immobility 24,25 Analgesic effect 2 Reduces the risk of breast cancer 2 o Treating 125 women for three years with raloxifene may prevent one case of breast cancer 26 Doses may be held during admissions due to increased risk of thromboembolism with immobility 37,38 Women in their 50s or 60s in general have a higher risk of vertebral vs hip fracture 19
6 (Clinical Resource #330702: Page 6 of 10) Class/Cost f (Medication[s]) Calcitonin nasal spray (U.S. only) (Generics only) (~$900 per year) Parathyroid Hormone Analogs Abaloparatide (Tymlos [U.S.]) Teriparatide (Forteo) (Abaloparatide: ~$19,500 per year [U.S.] Teriparatide: ~$36,000 per year [U.S.]; ~$12,500 per year [Canada]) Continued NNT to prevent one fracture over 3 yrs c Consider for Avoid in patients Comments Vertebral fracture: 6 12 (in patients with prior vertebral fracture) Vertebral fracture: Abaloparatide: d,22 28 Teriparatide: b,14 11 Nonvertebral fracture: Abaloparatide: b,36 50 Teriparatide: b,14,33 33 So far, have not been shown to specifically reduce hip fractures. 33,36 Treatment in postmenopausal women: 3,e who cannot use a bisphosphonate 2 with bone pain from vertebral compression fractures 2 Treatment in postmenopausal women: 2,4,22,28,39 with high fracture risk (e.g., corticosteroid induced osteoporosis, previous osteoporotic fracture, multiple risk factors, very low BMD) those who failed or cannot use other agents Teriparatide may also be considered: with primary or hypogonadal osteoporosis (men) 4 with corticosteroidinduced osteoporosis 31 after considering oral/iv bisphosphonates 4,39 In whom hip fracture is the primary concern Less than 5 years postmenopausal (not proven effective) 16 Abaloparatide: With pre-existing hypercalcemia or an underlying hypercalcemic disorder, (e.g., primary hyperparathyroidism) Teriparatide: With metabolic bone disease 2 With Paget s disease 4 With previous skeletal irradiation 4 With elevated alkaline phosphatase of unknown etiology 4 With severe renal impairment 2 Side effects include nausea, flushing, and runny nose 4 Not a first-line drug for osteoporosis. 16,23 o Does not have strong fracture efficacy and it has less effect on BMD than other osteoporosis meds 16 o Clinical significance of its relief of vertebral fracture pain unclear 18 No data available on missed doses and impact on prevention of osteoporosis. o Hospitalized patients may need to use home meds to avoid missed doses if not on formulary Daily subcutaneous injection 2,22 Abaloparatide: if patients experience orthostatic hypotension they should sit or lie down after each dose 22 Side effects may include abdominal pain (abaloparatide), dizziness, fatigue (abaloparatide), headache, hypercalciuria (abaloparatide), leg cramps (teriparatide), and nausea 2,22 Abaloparatide: monitor urine calcium in patients with previous hypercalciuria or if suspect kidney stones 22 Use for max of 2 years due to dosedependent risk of osteosarcoma in rats 2,14,17,22,28 o 2-yr treatment course may be followed by bisphosphonate to maintain BMD 2 Abaloparatide: based on a small study (n=31) no dosage adjustment needed with renal impairment. 22 However,
7 (Clinical Resource #330702: Page 7 of 10) Class/Cost f (Medication[s]) Parathyroid Hormone Analogs, continued RANKL inhibitor Denosumab (Prolia) (~$2,100 per year U.S.; ~$800 per year in Canada) NNT to prevent one Consider for Avoid in patients Comments fracture over 3 yrs c Vertebral fracture: 5 21 Hip fracture: Treatment in patients with high fracture risk (e.g., previous fracture, multiple risk factors): 2,9 with postmenopausal osteoporosis, especially those who have failed or can t/won t take bisphosphonates, such as those with renal insufficiency 2,4,9,23,28 with prostate cancer, receiving androgen deprivation therapy for prostate cancer 8 with breast cancer, receiving an aromatase inhibitor 8 with corticosteroidinduced osteoporosis unable to take oral or IV bisphosphonate or parathyroid hormone analogs 39 With stage 5 kidney disease or patients on dialysis due to high risk of hypocalcemia 28 With hypocalcemia 2 patients with severe renal impairment may be at higher risk for adverse effects. Teriparatide: caution with moderate renal impairment 2 Patients will likely need to continue to use home meds when hospitalized, due to significant cost, as these meds will likely not be on formulary. If doses are missed, resume doses as soon as able. Do not try to catch up on missed doses. 17 Subcutaneous injection given every 6 months, by healthcare professional (U.S.) or patients after training (Canada) 8,9 Dermatologic reactions and cellulitis reported 2 Consider stopping after 5 years [Evidence level C; expert opinion]. 23 Reduction in fracture risk may be maintained for up to two years after discontinuation of therapy. 30 o However BMD may rapidly decline with discontinuation, so many experts recommend starting another osteoporosis med prior to stopping (e.g., bisphosphonate) 28 Potential for jaw osteonecrosis and atypical fractures 8,9 o Jaw osteonecrosis may occur in up to 1.7% of patients treated with denosumab. 27 If doses are missed due to hospitalization, administer dose as soon as able and schedule next dose 6 months following administered dose 8,9
8 (Clinical Resource #330702: Page 8 of 10) a. Alendronate does not have monthly dosing. Ibandronate does not have weekly dosing. b. Over 19 months. 14 c. All numbers needed to treat (NNT) are in comparison to placebo. These medications haven t been directly compared to one another. d. Over 18 months. 22,36 e. Though approved for use, calcitonin nasal spray is no longer widely used for osteoporosis and therefore not considered in the most recent 2017 guidelines. 23 f. U.S. cost information is wholesale acquisition cost (WAC). Users of this resource are cautioned to use their own professional judgment and consult any other necessary or appropriate sources prior to making clinical judgments based on the content of this document. Our editors have researched the information with input from experts, government agencies, and national organizations. Information and internet links in this article were current as of the date of publication.
9 (Clinical Resource #330702: Page 9 of 10) Levels of Evidence In accordance with the trend towards Evidence-Based Medicine, we are citing the LEVEL OF EVIDENCE for the statements we publish. Level Definition A High-quality randomized controlled trial (RCT) High-quality meta-analysis (quantitative systematic review) B Nonrandomized clinical trial Nonquantitative systematic review Lower quality RCT Clinical cohort study Case-control study Historical control Epidemiologic study C Consensus Expert opinion D Anecdotal evidence In vitro or animal study Adapted from Siwek J, et al. How to write an evidence-based clinical review article. Am Fam Physician 2002;65: Project Leader in preparation of this clinical resource (330702): Beth Bryant, Pharm.D., BCPS, Assistant Editor References 1. Ringe JD, Doherty JG. Absolute risk reduction in osteoporosis: assessing treatment efficacy by number needed to treat. Rheumatol Int 2010;30: Silverman S, Christiansen C. Individualizing osteoporosis therapy. Osteoporos Int 2012;23: Maclaughlin EJ, Sleeper RB, McNatty D, Raehl CL. Management of age-related osteoporosis and prevention of associated fractures. Ther Clin Risk Manag 2006;2: Florence R, Allen S, Benedict L, et al. Institute for Clinical Systems Improvement (ICSI): diagnosis and treatment of osteoporosis. Guideline summary. Revised July gnosis-and-treatment-of-osteoporosis. (Accessed May 30, 2017). 5. Cummings SR, San Martin J, McClung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009;361: Chesnut CH, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. Am J Med 2000;109: Black DM, Bauer DC, Schwartz AV, et al. Continuing bisphosphonate treatment for osteoporosis--for whom and for how long? N Engl J Med 2012;366: Product information for Prolia. Amgen Inc. Thousand Oaks, CA January Product monograph for Prolia. Amgen Canada Inc. Mississauga, ON L5N 0A4. April Product information for Reclast. Novartis Pharmaceuticals Corporation. East Hanover, NJ April Product monograph for Aclasta. Novartis Pharmaceuticals Canada Inc. Dorval, QC H9S 1A9. April Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA 1999;282: Nelson HD, Walker M, Zakher B, Mitchell J. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the U.S. Preventive Services Task Force recommendations. Ann Intern Med 2012;157: Product information for Forteo. Lilly USA, LLC. Indianapolis, IN October Watts NB, Adler RA, Bilezikian JP, et al. Osteoporosis in men: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012;97: Management of osteoporosis in postmenopausal women: 2010 position statement of the North American Menopause Society. Menopause 2010;17: Product monograph for Forteo. Eli Lilly Canada Inc. Toronto, ON M1N 2E8. February Bandolier. Calcitonin for pain relief following acute osteoporotic vertebral fractures. muscskel/cp104.html. (Accessed May 29, 2017). 19. Skugor M. Osteoporosis. Cleveland Clinic. Center for Continuing Education. seasemanagement/endocrinology/osteoporosisdisease/. (Accessed May 30, 2017). 20. Product information for Boniva injection. Genentech USA, Inc. South San Francisco, CA December Orwoll E, Ettinger M, Weiss S, et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med 2000;343: Product information for Tymlos. Radius Health Inc. Waltham, MA April Qaseem A, Forciea MA, McLean RM, Denberg TD. Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians. Ann Intern Med 2017;166: Product information for Duavee. Wyeth Pharmaceuticals Inc. A subsidiary of Pfizer Inc. Philadelphia, PA September Kumar V, Sinha RK. Bisphosphonate related osteonecrosis of the jaw: an update. J Maxillofac Oral Surg 2014;13:
10 (Clinical Resource #330702: Page 10 of 10) 26. Kinsinger L, Harris R, Lewis C, et al. Chemoprevention of Breast Cancer [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2002 Jul. (Systematic Evidence Reviews, No. 8.) 4, Discussion. Available from: (Accessed May 31, 2017). 27. Olate S, Uribe F, Martinez F, et al. Osteonecrosis of the jaw in patient with denosumab therapy. Int J Clin Exp Med 2014;7: Camacho PM, Petak SM, Binkley N, et al. American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis Endocr Pract 2016;22: Jeremiah MP, Unwin BK, Greenawald MH, Casiano VE. Diagnosis and management of osteoporosis. Am Fam Physician 2015;92: Brown JP, Roux C, Torring O, et al. Discontinuation of denosumab and associated fracture incidence: analysis from the fracture reduction evaluation of denosumab in osteoporosis every 6 months (FREEDOM) trial. J Bone Miner Res 2013;28: Saag KG, Zanchetta JR, Devogelaer JP, et al. Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: thirty-six-month results of a randomized, double-blind, controlled trial. Arthritis Rheum 2009;60: Adler RA, El-Hajj Fuleihan G, Bauer DC, et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2016;31: Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001;334: Diab DL, Watts NB. Bisphosphonate drug holiday: who, when and how long. Ther Adv Musculoskelet Dis 2013;5: Product monograph for Duavive. Pfizer Canada Inc. Kirkland, QC H9J 2M5. October Miller PD, Hattersley G, Riis BJ, et al. Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial. JAMA 2016;316: Product information for Evista. Lilly USA. Indianapolis, IN December Product monograph for Evista. Lilly Canada. Toronto, ON M1N 2E8. October Buckley L, Guyatt G, Fink HA, et al American College of Rheumatology guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2017 June 6. doi: /acr [Epub ahead of print]. 40. Toward Optimized Practice. Diagnosis and management of osteoporosis clinical practice guideline, February eoporosis%20cpg.pdf?_ (Accessed June 21, 2017). Cite this document as follows: Clinical Resource, Managing Osteoporosis: Screening, Treatment, and More. Pharmacist s Letter/Prescriber s Letter. July Evidence and Recommendations You Can Trust 3120 West March Lane, Stockton, CA ~ TEL (209) ~ FAX (209) Subscribers to the Letter can get clinical resources, like this one, on any topic covered in any issue by going to PharmacistsLetter.com, PrescribersLetter.com, PharmacyTechniciansLetter.com, or NursesLetter.com
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 informationPharmacy 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 informationParathyroid 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 informationOsteoporosis 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 informationTymlos (abaloparatide)
Tymlos (abaloparatide) Policy Number: 5.01.638 Last Review: 11/2018 Origination: 10/2017 Next Review: 11/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Tymlos
More informationPharmacy 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 informationWhat 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 informationPharmacy 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 informationForteo (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 informationThe 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 informationAETNA BETTER HEALTH Prior Authorization guideline for Injectable Osteoporosis Agents
AETNA BETTER HEALTH Prior Authorization guideline for Injectable Osteoporosis Agents Injectable Osteoporosis Agents Forteo (teriparatide); zoledronic acid Prolia (denosumab)] Authorization guidelines For
More informationThis 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 informationOsteoporosis. 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 informationOsteoporosis Management
Osteoporosis Management Lisa Voss PA C, CCD Laura Frontiero NP C, CCD Kaiser Healthy Bones Program San Diego Disclosures: Nothing to disclose www.zazzle.com 1 Overview How to diagnose Osteoporosis FRAX
More informationAACE/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 informationBisphosphonates. Making intelligent drug choices
Making intelligent drug choices Bisphosphonates are a first choice for treating osteoporosis, according to Kedrin E. Van Steenwyk, DO, an obstetrician/gynecologist at Sycamore Women s Center, Miamisburg,
More informationDownload 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 informationHARVARD PILGRIM HEALTH CARE RECOMMENDED MEDICATION REQUEST GUIDELINES
Generic Brand HICL GCN Exception/Other PROLIA, XGEVA 37012 If the caller wishes to initiate a request then a MRF must be completed. This drug requires a written request for prior authorization. All requests
More informationOsteoporosis. 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 informationDoes raloxifene (Evista) prevent fractures in postmenopausal women with osteoporosis?
FPIN's Clinical Inquiries Raloxifene for Prevention of Osteoporotic Fractures Clinical Inquiries provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries
More informationOsteoporosis: 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 informationCASE 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 informationNew 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 informationJohn 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 informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Forteo) Reference Number: CP.PHAR.188 Effective Date: 11.15.17 Last Review Date: 02.19 Line of Business: Commercial* (Exchange Plans), HIM, Medicaid Coding Implications Revision Log See
More informationMAKE NO BONES ABOUT IT: UNDERSTANDING THE PHARMACIST S ROLE IN OSTEOPOROSIS MANAGEMENT. Jill Hiers, Pharm.D., BCPS
MAKE NO BONES ABOUT IT: UNDERSTANDING THE PHARMACIST S ROLE IN OSTEOPOROSIS MANAGEMENT Jill Hiers, Pharm.D., BCPS Outline Definition of osteoporosis/osteopenia Disease prevalence/burden Risk Factors AACE
More informationParathyroid 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 informationKristen 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 informationOSTEOPOROSIS IN MEN. Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO
OSTEOPOROSIS IN MEN Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO DISCLOSURES Speakers Bureau: Amgen, Radius Consultant: Abbvie, Amgen, Janssen, Radius, Sanofi Watts NB et
More informationOsteoporosis: 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 informationNEW 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 information1
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 informationEffective Health Care
Number 12 Effective Health Care Comparative Effectiveness of Treatments To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis Executive Summary Background Osteoporosis is a systemic
More informationFocusing 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 informationChau 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 informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Reclast, Zometa) Reference Number: CP.PHAR.59 Effective Date: 03.11 Last Review Date: 02.18 Line of Business: Commercial, Medicaid Coding Implications Revision Log See Important Reminder
More informationOsteoporosis. 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 informationOsteoporosis/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 informationCurrent Issues in Osteoporosis
Current Issues in Osteoporosis California AACE 18TH Annual Meeting & Symposium Marina del Rey, CA September 15, 2018 Michael R. McClung, MD, FACP,FACE Director, Oregon Osteoporosis Center Portland, Oregon,
More informationApproval of a drug under this criteria document does not ensure full coverage of the drug.
Criteria Document: Reference #: PC/A011 Page 1 of 8 PRODUCT APPLICATION: PreferredOne Administrative Services, Inc. (PAS) ERISA PreferredOne Administrative Services, Inc. (PAS) Non-ERISA PreferredOne Community
More informationHorizon 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 informationDisclosure. Objectives. Osteoporosis. Major Public Health Concern Will I end up like my mother?
Everything a Pharmacist Needs to Know About Osteoporosis New Mexico Pharmacists Association Mid-Winter Meeting January 27-28, 2018 Albuquerque, NM Consulting Amgen, Radius Speaking Radius Disclosure E.
More informationOSTEOPOROSIS 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 informationPage 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 informationCurrent 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 informationOsteoporosis 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 informationUpdate 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 informationClinical 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 informationResearchers estimate that approximately 10.2 million
Osteoporosis: A quick update This review of the latest recommendations regarding screening and Tx regimens can help you refine your approach and reduce patients risk of s. Lovedhi Aggarwal, MD; Camlyn
More informationTREATMENT OF OSTEOPOROSIS HOLIDAYS OR NO HOLIDAYS? Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO
TREATMENT OF OSTEOPOROSIS HOLIDAYS OR NO HOLIDAYS? Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO DISCLOSURES Honoraria: Amgen, Merck, Shire Consulting : AbbVie, Amgen, Merck,
More informationOSTEOPOROSIS: 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 informationTymlos (abaloparatide) NEW PRODUCT SLIDESHOW
Tymlos (abaloparatide) NEW PRODUCT SLIDESHOW Introduction Brand name: Tymlos Generic name: Abaloparatide Pharmacological class: Human parathyroid hormone related peptide analog Strength and Formulation:
More informationLearning 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 informationMen 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 informationOSTEOPOROSIS MANAGEMENT AND INVESTIGATION. David A. Hanley, MD, FRCPC
OSTEOPOROSIS MANAGEMENT AND INVESTIGATION David A. Hanley, MD, FRCPC There is a huge care gap in the management of osteoporosis in this country. As yet unpublished findings from the Canadian Multicentre
More informationPage 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 informationOsteoporosis. 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 informationOsteoporosis 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 informationBreast 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 informationControversies in Osteoporosis Management
Controversies in Osteoporosis Management 2018 Northwest Rheumatism Society Meeting Portland, OR April 28, 2018 Michael R. McClung, MD, FACP Director, Oregon Osteoporosis Center Portland, Oregon, USA Institute
More informationOsteoporosis 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 informationS H A R E D C A R E G U I D E L I N E Drug: Denosumab 60mg injection Indication: treatment of osteoporosis in postmenopausal women
S H A R E D C A R E G U I D E L I N E Drug: Denosumab 60mg injection Indication: treatment of osteoporosis in postmenopausal women Introduction Indication: Denosumab (Prolia ) is recommended in NICE TA204
More informationDisclosures. Osteoporosis and Fracture Prevention. Objectives. Objectives. Osteoporosis Overview. Advisory Board: Hologic Advisory Board: LabCorp
Disclosures Osteoporosis and Fracture Prevention Advisory Board: Hologic Advisory Board: LabCorp Nancy R. Berman MSN, ANP-BC, NCMP, FAANP Adult Nurse Practitioner/Colposcopist Certified Menopause Practitioner
More information11/4/2018. Osteoporosis Update. ACP Oregon Chapter November 9 th, 2018 Sarah Hopkins Providence Medical Group Endocrinology East. No disclosures.
Osteoporosis Update ACP Oregon Chapter November 9 th, 2018 Sarah Hopkins Providence Medical Group Endocrinology East No disclosures. 1 Goals Review screening recommendations and workup of secondary causes
More informationName 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 informationOsteoporosis. 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 informationOsteoporosis/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 informationFYI ONLY Generic Name. Generics available. zoledronic acid N/A
Criteria Document: Reference #: PC/A011 Page 1 of 5 PRODUCT APPLICATION: PreferredOne Administrative Services, Inc. (PAS) ERISA PreferredOne Administrative Services, Inc. (PAS) Non-ERISA PreferredOne Community
More informationReducing the Risk of Fracture in Postmenopausal Women: Guidance for Family Physicians. Please complete the preassessment before the session starts.
Reducing the Risk of Fracture in Postmenopausal Women: Guidance for Family Physicians Please complete the preassessment before the session starts. Sponsorship and Support This educational activity is jointly
More informationAdvanced 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 informationBone 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 informationPage 1. Diagnosis and Treatment of Osteoporosis: What s New and Controversial in 2018? What s New in Osteoporosis
Diagnosis and Treatment of Osteoporosis: What s New and Controversial in 2018? Douglas C. Bauer, MD Professor of Medicine and Epidemiology & Biostatistics University of California, San Francisco What s
More informationNAMS Practice Pearl. Use of Drug Holidays in Women Taking Bisphosphonates. Released April 1, 2013
NAMS Practice Pearl Use of Drug Holidays in Women Taking Bisphosphonates Released April 1, 2013 Dima L. Diab, MD 1, and Nelson B. Watts, MD 2 ( 1 Cincinnati VA Medical Center, Cincinnati, OH, 2 Mercy Health
More informationBisphosphonate treatment break
Bulletin 110 December 2015 Bisphosphonate treatment break Bisphosphonates have been widely used in the treatment of osteoporosis with robust data demonstrating efficacy in fracture risk reduction over
More informationTreatments 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 informationOsteoporosis 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 informationEmerging Challenges in Primary Care: Osteoporosis and Fracture Prevention Strategies
Emerging Challenges in Primary Care: 2017 Osteoporosis and Fracture Prevention Strategies Faculty Nancy R. Berman, MSN, ANP-BC, NCMP, FAANP Adult Nurse Practitioner Certified Menopause Practitioner Millennium
More informationEmerging Challenges in Primary Care: Osteoporosis and Fracture Prevention Strategies. Faculty. Disclosures. [Insert Lecture Name Here]
Emerging Challenges in Primary Care: 2017 Osteoporosis and Fracture Prevention Strategies Faculty Nancy R. Berman, MSN, ANP-BC, NCMP, FAANP Adult Nurse Practitioner Certified Menopause Practitioner Millennium
More informationFracture=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 informationOsteoporosis: A Review of Treatment Options
Kristie N. Tu, PharmD, BCPS, CGP; Janette D. Lie, PharmD, BCACP; Chew King Victoria Wan, PharmD Candidate; Madison Cameron, PharmD Candidate; Alaina G. Austel, PharmD Candidate; Jenny K. Nguyen, PharmD
More informationOsteoporosis: 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 informationDiagnosis and Treatment of Osteoporosis: What s New and Controversial in ? What s New in Osteoporosis
Diagnosis and Treatment of Osteoporosis: What s New and Controversial in 2018-19? What s New in Osteoporosis The crisis in treatment and compliance Douglas C. Bauer, MD Professor of Medicine and Epidemiology
More informationClinical Policy: Abaloparatide (Tymlos) Reference Number: CP.CPA.306 Effective Date: Last Review Date: Line of Business: Commercial
Clinical Policy: (Tymlos) Reference Number: CP.CPA.306 Effective Date: 06.13 Last Review Date: 08.17 Line of Business: Commercial Revision Log See Important Reminder at the end of this policy for important
More information9/9/2015 OSTEOPOROSIS WHAT S NEW AND ON THE HORIZON IN SCREENING, DRUG HOLIDAYS, SUPPLEMENTS, CONSERVATIVE THERAPY DISCLOSURES
OSTEOPOROSIS WHAT S NEW AND ON THE HORIZON IN SCREENING, DRUG HOLIDAYS, SUPPLEMENTS, CONSERVATIVE THERAPY Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO DISCLOSURES Stock options/holdings,
More informationModule 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 informationOSTEOPOROSIS 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 informationDisclosures. 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 informationTREATING OSTEOPOROSIS IN 2018: WHAT'S OLD, WHAT'S NEW, WHAT'S UNPROVEN AND WHAT'S TRUE. Nelson B. Watts, MD
TREATING OSTEOPOROSIS IN 2018: WHAT'S OLD, WHAT'S NEW, WHAT'S UNPROVEN AND WHAT'S TRUE Nelson B. Watts, MD OSTEOPOROSIS AND BONE HEALTH SERVICES CINCINNATI, OHIO Honoraria: Amgen, Radius, Shire Consulting
More informationACP 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 informationVol. 19, Bulletin No. 108 August-September 2012 Also in the Bulletin: Denosumab 120mg for Bone Metastases
ה מ ר א פ הביטאון לענייני תרופות ISRAEL DRUG BULLETIN 19 years of unbiased and independent drug information P H A R x M A Vol. 19, Bulletin No. 108 August-September 2012 Also in the Bulletin: Denosumab
More informationBone 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 informationOsteoporosis. 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 information2017 Santa Fe Bone Symposium McClung
217 Santa Fe Bone Symposium Insights into the Use of Anti-remodeling and Anabolic Agents for Osteoporosis Developing a Long-term Management Plan Michael R., MD, FACP Oregon Osteoporosis Center Portland,
More informationRheumatology. keeping Joints in Motion. Treating and Preventing Fractures
Rheumatology keeping Joints in Motion Treating and Preventing Fractures Robin K. Dore, MD Clinical Professor of Medicine David Geffen School of Medicine at UCLA, Los Angeles CA Private practice, Tustin
More informationManagement 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 informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Prolia, Xgeva) Reference Number: CP.PHAR.58 Effective Date: 03.01.11 Last Review Date: 02.19 Line of Business: Commercial, HIM, Medicaid Coding Implications Revision Log See Important
More informationPrevalence 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 informationFORTEO (teriparatide) INJECTION
FORTEO (teriparatide) INJECTION Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical Coverage
More informationSummary. 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