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

Size: px
Start display at page:

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

Transcription

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

2 Outline What is Osteoporosis? Who is at risk? What treatments are available? Role of the Pharmacy technician

3 Definition of Osteoporosis Bone disorder characterized by low bone strength resulting in bone fragility and an increased risk of fractures Bone strength depends upon two features: Bone density Bone quality Occurs when the rate of bone loss exceeds the rate of bone formation over an extended period

4

5 The bone remodeling cycle. Derived from Roodman GD. N Engl J Med. 2004;350:

6 Assessment for Osteoporosis Who should be assessed? Women and men over 50 to identify those at high risk Anyone over 50 who has experienced a fragility fracture How is the Assessment Done? Detailed history to identify risk factors for low BMD, future fractures and falls: Prior fragility fracture Parental hip fracture Glucocorticoid use Current smoking High alcohol intake (3 or more drinks per day)

7 Assessment for Osteoporosis Rheumatoid arthritis Inquire about falls in past 3 months Inquire about gait and balance Physical examination Measure weight Screening for vertebral fractures: Measure height annually Measure rib to pelvis distance Measure occiput-to to-wall distance Spinal x-ray x indicated if there is evidence of vertebral fracture Assess fall risk by using Get-Up Up-and-Go Test

8 (CAROC) CAROC) - Canadian Association of Radiologists and Osteoporosis Canada Other factors in addition to (hip) BMD results are used to determine 10-year fracture risk These factors are age, sex, fracture history and glucocorticoid use FRAX Tools for Assessment In 2008, the World Health Organization (WHO) launched FRAX, a web-based based fracture risk assessment tool. In 2010 Canadian data were added. In addition to femoral neck (hip) BMD, age, gender, fracture history and steroid use, FRAX also takes into account other risk factors to calculate the absolute 10-year risk of a hip fracture or other major osteoporotic fracture (spine, forearm, upper arm).

9 Goal of drug treatment: Prevention of osteoporosis in high risk people Prevention of further bone loss Rebuild healthy bone Fracture prevention Fall prevention

10 Medications Associated with Increased Risk of Osteoporosis Oral steroids (e.g. Prednisone, Dexamethasone) Depo-Provera Anti-seizure drugs (e.g. Phenytoin, Carbamazepine, Phenobarbital) Cyclosporin Lithium SSRI s s (implicated) Anti-estrogen drugs (e.g.?tamoxifen, Anastrozole, Letrozole, Exemestane)

11 Disorders Associated with an Increased Risk of Osteoporosis Irritable Bowel Syndrome Celiac disease Rheumatoid arthritis Ankylosing Spondylitis Lymphoma Leukemia Pernicious Anemia Multiple Sclerosis Breast Cancer...

12 Drug categories Bisphosphonates Etidronate/Didronel tm Alendronate/ Fosamax tm Risedronate/ Actonel tm Zoledronic acid /Aclasta Ibandronate/Boniva Denosumab SERMs Raloxifene - Evista tm Calcitonin /Miacalcin tm HRT PTH (Forteo) Fluoride Vitamin D Calcium Strontium ranelate/ Protos tm

13 Medication activity Bone resorption inhibitors Bisphosphonates SERM s HRT Calcitonin Bone formation stimulators Parathyroid hormone Fluoride Monoclonal antibody

14 Bisphosphonates Bind to bone and slow down bone-eroding eroding cells (osteoclasts) Alendronate (Fosamax ), Risedronate (Actonel ), Etidronate (Didrocal ) Pamidronate (Aredia ), Zoledronate (Zometa )Zoledronic Acid (Aclasta) Can be used for both prevention and treatment of osteoporosis

15 Bisphosphonates: Mechanism of Action Roger M. Bone 1999,24, 739

16 Treatment Controversies Jaw Necrosis pamidronate and zolendronate IV in patients treated for cancer and not osteoporosis; This side effect is rare, but a concern nevertheless since it is thought to affect all bisphosphonates. Rare reports have been described with alendronate Text (Fosamax ) ) or risedronate (Actonel ). Increased Risk of Atypical Fractures long-term alendronate use further studies needed to establish whether a clear association exists thigh fracture associated with bisphosphonate use is extremely rare, on the other hand, fractures due to osteoporosis are extremely common

17 Lifestyle Changes Increase physical activity (weight-bearing exercise) Reduce/eliminate tobacco Reduce/eliminate caffeine intake Reduce/eliminate alcohol intake Minimize risk of falling ENSURE ADEQUATE CALCIUM AND VITAMIN D INTAKE...

18 Diet and Bone Health Calcium: Bone is really a bank,, or place where the body can store and retrieve calcium - the mineral that makes bone hard. Vitamin D: Is needed to make sure the body can absorb calcium from food.

19 Age Calcium Needs 1-3 yrs 500 mg mg mg mg mg mg Nat l l Academy of Sci 1997 OSC 2001

20 Vitamin D House bound elderly at greatest risk of deficiency Sun exposure is not enough to replace ingested Recommendations by age: AGE DAILY INTAKE 19 to IU IU

21 Pharmacy Technicians role Patient education Know required amounts of calcium and Vitamin D at various stages in life Know correct amounts of Ca not more than 500mg at one time Watch for patients on any of the potential bone- loss medications and advise accordingly Be attentive to pt s s complaining of falling or dizziness and refer patient to the pharmacist pt s s refusing to take Ca supplements due to media reports of it causing heart attacks should be referred to the pharmacist

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

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

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

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. 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

Prevention of Osteoporotic Hip Fracture

Prevention of Osteoporotic Hip Fracture Prevention of Osteoporotic Hip Fracture Dr Law Sheung Wai 8th July 2007 Associate Consultant Spine team / Orthopedic Rehabilitation Department of Orthopedics and Traumatology NTE Cluster 1 Objectives Problems

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

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 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

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

Closing the Care Gap in Osteoporosis ICE Conference 2015

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

More information

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

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

More information

Osteoporosis. 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. 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: 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 Agents Drug Class Prior Authorization Protocol

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

More information

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

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

More information

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

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

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

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 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

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

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

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

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

Bisphosphonates. Making intelligent drug choices

Bisphosphonates. 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 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

BREAST CANCER AND BONE HEALTH

BREAST CANCER AND BONE HEALTH BREAST CANCER AND BONE HEALTH Rowena Ridout, MD, FRCPC Toronto Western Hospital Osteoporosis Program University Health Network / Mount Sinai Hospital rowena.ridout@uhn.ca None to declare Conflicts of Interest

More information

COURSE OUTLINE - Module I

COURSE OUTLINE - Module I Module I MEDICAL DISCLAIMER The information in this program is for educational purposes only. It is meant to as a guide towards health and does not replace the evaluation by and advice of a qualified licensed

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

Trends in Glucocorticoid-Induced Osteoporosis Management Among Seniors in Ontario,

Trends in Glucocorticoid-Induced Osteoporosis Management Among Seniors in Ontario, Trends in Glucocorticoid-Induced Osteoporosis Management Among Seniors in Ontario, 1996-2012 Jordan M Albaum 1, Linda E Lévesque 2, Andrea S Gershon 3, Yan Yun Liu 1, Suzanne M Cadarette 1 1 Leslie Dan

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

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

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

More information

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

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

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

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

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

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

More information

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

Clinician s Guide to Prevention and Treatment of Osteoporosis

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

More information

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

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

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

Cortical bone After age 40, gradually decreases % yearly, in both men and women Postmenopausally, loss accelerates to 2-3% yearly

Cortical bone After age 40, gradually decreases % yearly, in both men and women Postmenopausally, loss accelerates to 2-3% yearly Osteoporosis POOLE, K.E.S. & COMPSTON, J.E. (2006): Osteoporosis and its management. BMJ 333:1251-6. Physiology Cortical bone After age 40, gradually decreases 0.3-0.5% yearly, in both men and women Postmenopausally,

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

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

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

Hot Topics in Osteoporosis and Fracture Prevention

Hot Topics in Osteoporosis and Fracture Prevention Hot Topics in Osteoporosis and Fracture Prevention Sid Feldman, MD CCFP (COE) FCFP Sandra Kim, MD, FRCPC November 15, 2018 Family Medicine Forum, Toronto Faculty/Presenter Disclosure Faculty: Sid Feldman

More information

Osteoporosis. Osteoporosis ADD PICTURE

Osteoporosis. Osteoporosis ADD PICTURE OSTEOPOROSIS The Silent Thief Chronic, progressive metabolic bone disease marked by Low bone mass Deteriora?on of bone?ssue Leads to increased bone fragility ADD PICTURE Osteoporosis Over 54 million people

More information

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

New Osteoporosis Guidelines: What you and your health provider need to know QUESTION & ANSWER The first of the newsletters on these Qs and As should include a refresher on the Virtual Forums what they are, how they work, etc. The fact is that less than 5% of COPN members tune in for any given Forum.

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

Understanding NICE guidance. NICE technology appraisal guidance advises on when and how drugs and other treatments should be used in the NHS.

Understanding NICE guidance. NICE technology appraisal guidance advises on when and how drugs and other treatments should be used in the NHS. Understanding NICE guidance Information for people who use NHS services Alendronate, etidronate, risedronate, strontium ranelate and raloxifene for preventing bone fractures in postmenopausal women with

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

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

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

The Osteoporosis Center at St. Luke s Hospital

The Osteoporosis Center at St. Luke s Hospital The Osteoporosis Center at St. Luke s Hospital Desloge Outpatient Center (on the west side of 141) 121 St. Luke s Center Drive, Suite 504 Chesterfield, MO 63017 Phone 314 205-6633 Fax 314 590-5909 NEW

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

Vol. 19, Bulletin No. 108 August-September 2012 Also in the Bulletin: Denosumab 120mg for Bone Metastases

Vol. 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 information

SOUTH TEXAS FRACTURE PREVENTION CLINIC PRE-DEXA PATIENT QUESTIONNAIRE

SOUTH TEXAS FRACTURE PREVENTION CLINIC PRE-DEXA PATIENT QUESTIONNAIRE OFFICE USE ONLY SOUTH TEXAS FRACTURE PREVENTION CLINIC PRE-DEXA PATIENT QUESTIONNAIRE PLACE STICKER HERE Name: Date of Birth: Male Female Primary Care Physician Name: Phone Number: Referring Physician

More information

Bone Densitometry Pathway

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

More information

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

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

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 ASSESSMENT CENTER

OSTEOPOROSIS ASSESSMENT CENTER OSTEOPOROSIS ASSESSMENT CENTER BOARD CERTIFIED RHEUMATOLOGISTS HERBERT S.B. BARAF, MD FACP MACR DAVID G. BORENSTEIN, MD FACP FACR ASHLEY D. BEALL, MD FACR ROBERT L. ROSENBERG, MD FACR CCD ROBERT J. LLOYD,

More information

Questions and Answers About Breast Cancer, Bone Metastases, & Treatment-Related Bone Loss. A Publication of The Bone and Cancer Foundation

Questions and Answers About Breast Cancer, Bone Metastases, & Treatment-Related Bone Loss. A Publication of The Bone and Cancer Foundation Questions and Answers About Breast Cancer, Bone Metastases, & Treatment-Related Bone Loss A Publication of The Bone and Cancer Foundation Contents This publication includes important information about

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

Costing statement: Denosumab for the prevention of osteoporotic fractures in postmenopausal women

Costing statement: Denosumab for the prevention of osteoporotic fractures in postmenopausal women Costing statement: Denosumab for the prevention of osteoporotic fractures in postmenopausal women Resource impact The guidance Denosumab for the prevention of osteoporotic fractures in postmenopausal women

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

OSTEOPOROSIS MANAGEMENT AND INVESTIGATION. David A. Hanley, MD, FRCPC

OSTEOPOROSIS 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 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

Vasu Pai FRACS, Nat Board, MCh, M.S

Vasu Pai FRACS, Nat Board, MCh, M.S Vasu Pai FRACS, Nat Board, MCh, M.S Composition of bone Mineral 70% Protein 22% Water 8% On osteoclast precurssor On Osteoblast Osteoporosis Dx No clinical lsigns No blood tests Gold standard: Bone

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

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

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

More information

Medical Review. The following slides were medically reviewed by Dr. Nancy Dawson in June 2018.

Medical Review. The following slides were medically reviewed by Dr. Nancy Dawson in June 2018. Bone Health Medical Review The following slides were medically reviewed by Dr. Nancy Dawson in June 2018. Presentation Overview 1. What is bone health? 2. How can cancer and cancer treatments affect your

More information

Osteoporosis. Information leaflet. This information is also available on request in other formats by phoning

Osteoporosis. Information leaflet. This information is also available on request in other formats by phoning Osteoporosis This information is also available on request in other formats by phoning 01387 241053. Information leaflet Produced by Katrina Martin (2007) Updated Mar. 2010 Review date 2013 Contents Page(s)

More information

Acknowledgement of Privacy Statement, Authorization and Assignments of Benefits. Release of Medical Information, Appointments and Prescriptions

Acknowledgement of Privacy Statement, Authorization and Assignments of Benefits. Release of Medical Information, Appointments and Prescriptions Acknowledgement of Privacy Statement, Authorization and Assignments of Benefits Patients Name (Please print) Date of Birth Guarantor s Name (Please print) Date of Birth (If patient is a minor or dependent)

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

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

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

More information

Osteoporosis Management

Osteoporosis 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 information

Fracture=Bone Attack:

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

More information

BONIVA (ibandronate sodium)

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

More information

Index. Rheum Dis Clin N Am 32 (2006) Note: Page numbers of article titles are in boldface type.

Index. Rheum Dis Clin N Am 32 (2006) Note: Page numbers of article titles are in boldface type. Rheum Dis Clin N Am 32 (2006) 775 780 Index Note: Page numbers of article titles are in boldface type. A AACE (American Association of Clinical Endocrinologists), bone mineral density recommendations of,

More information

Monitoring Osteoporosis Therapy

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

More information

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

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

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

Osteoporosis. Skeletal System

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

More information

4.7 Studies of Quality Holy Cross Hospital Bone Health Early Stage I ER/PR Positive Breast Cancer Patients December 13, 2017

4.7 Studies of Quality Holy Cross Hospital Bone Health Early Stage I ER/PR Positive Breast Cancer Patients December 13, 2017 4.7 Studies of Quality Holy Cross Hospital 2017 Bone Health Early Stage I ER/PR Positive Breast Cancer Patients December 13, 2017 Bone Health in Stage I ER/PR Positive Breast Cancer Patients To review

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

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

Practical Management Of Osteoporosis

Practical Management Of Osteoporosis Practical Management Of Osteoporosis CONFERENCE 2012 Education Centre, Bournemouth.19 November The following companies have given funding towards the cost of this meeting but have no input into the agenda

More information

Osteoporosis and Bone Health. Heather Schickedanz, MD Geriatric Knowledge Network, 08/10/16

Osteoporosis and Bone Health. Heather Schickedanz, MD Geriatric Knowledge Network, 08/10/16 Osteoporosis and Bone Health Heather Schickedanz, MD Geriatric Knowledge Network, 08/10/16 1 Learning Objectives Recognize the risk factors for osteoporosis Diagnose and treat osteoporosis Reduce the risk

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

Bisphosphonate treatment break

Bisphosphonate 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 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

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

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

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

Beyond the Break. After Breast Cancer: Osteoporosis in Survivorship. Dr Alexandra Ginty CCFP(EM) FCFP Regional Primary Care Lead CCO

Beyond the Break. After Breast Cancer: Osteoporosis in Survivorship. Dr Alexandra Ginty CCFP(EM) FCFP Regional Primary Care Lead CCO Beyond the Break After Breast Cancer: Osteoporosis in Survivorship Dr Alexandra Ginty CCFP(EM) FCFP Regional Primary Care Lead CCO Disclosures No disclosures Osteoporosis in Breast Cancer Survivorship

More information