Osteopenia: To Treat or Not To Treat?
2005; American College of Physicians; Volume: 142; Issue: 9 Linguagem: Inglês
10.7326/0003-4819-142-9-200505030-00018
ISSN1539-3704
Autores Tópico(s)Hip and Femur Fractures
ResumoEditorials3 May 2005Osteopenia: To Treat or Not To Treat?Michael R. McClung, MDMichael R. McClung, MDFrom Providence Portland Medical Center, Oregon Osteoporosis Center, Portland, OR 97213.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-9-200505030-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The availability of an accepted and widely available diagnostic test and a set of effective treatment options for osteoporosis has challenged clinicians in deciding which patients should be treated. Once diagnosed when older women experienced a fracture of the spine or hip, osteoporosis is now recognized as a disorder of impaired bone strength that predisposes to fracture (1). The diagnosis of osteoporosis in postmenopausal women is now based solely on bone mineral density (BMD) values (T-score ≤ −2.5), according to the World Health Organization (WHO) criteria (2). In postmenopausal women with previous vertebral fractures or with BMD values consistent with ...References1. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785-95. [PMID: 11176917] CrossrefMedlineGoogle Scholar2. World Health Organization. Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. Technical Report Series no. 843. Geneva: World Health Organization; 1994. Google Scholar3. Delmas PD. Treatment of postmenopausal osteoporosis. Lancet. 2002;359:2018-26. [PMID: 12076571] CrossrefMedlineGoogle Scholar4. Iglesias CP, Torgerson DJ, Bearne A, Bose U. The cost utility of bisphosphonate treatment in established osteoporosis. QJM. 2002;95:305-11. [PMID: 11978902] CrossrefMedlineGoogle Scholar5. Johnell O, Jönsson B, Jönsson L, Black D. Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics. 2003;21:305-14. [PMID: 12627984] CrossrefMedlineGoogle Scholar6. 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American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract. 2003;9:544-64. [PMID: 14715483] CrossrefMedlineGoogle Scholar14. National Osteoporosis Foundation. Physician's Guide to Prevention and Treatment of Osteoporosis. Washington DC: National Osteoporosis Foundation; 2003. Google Scholar15. Schousboe JT, Nyman JA, Kane RL, Ensrud KE. Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women. Ann Intern Med. 2005;142:734-41. LinkGoogle Scholar16. Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis. Introduction. Osteoporos Int. 1998;8 Suppl 4 S7-80. [PMID: 10197173] CrossrefMedlineGoogle Scholar17. Cummings SR, Black DM, Thompson DE, Applegate WB, Barrett-Connor E, Musliner TA, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280:2077-82. [PMID: 9875874] CrossrefMedlineGoogle Scholar18. Hamdy RC, Petak SM, Lenchik L. Which central dual X-ray absorptiometry skeletal sites and regions of interest should be used to determine the diagnosis of osteoporosis? J Clin Densitom. 2002;5 Suppl S11-8. [PMID: 12464707] CrossrefMedlineGoogle Scholar19. Kanis JA, Johnell O, Oden A, Dawson A, DeLaet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int. 2001;12:989-95. [PMID: 11846333] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Providence Portland Medical Center, Oregon Osteoporosis Center, Portland, OR 97213.Disclosures: Consultancies (Eli Lilly, Inc., Merck & Co., Procter & Gamble); Honoraria (Eli Lilly, Inc., Merck & Co., Procter & Gamble, Sanofi-Aventis); Grants received (Eli Lilly, Inc., Merck & Co., Procter & Gamble, Roche, Sanofi-Aventis).Corresponding Author: Michael R. McClung, MD, Oregon Osteoporosis Center, 5050 NE Hoyt, Suite 651, Portland, OR 97213; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Alendronate Therapy for Osteopenic Postmenopausal Women John T. Schousboe , John A. Nyman , Robert L. Kane , and Kristine E. Ensrud Metrics Cited ByOsteoporosis and osteopenia in the distal forearm predict all-cause mortality independent of grip strength: 22-year follow-up in the population-based Tromsø StudyEfficacy of group-adapted physical exercises in reducing back pain in women with postmenopausal osteoporosisImpact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trialThe Safety and Efficacy of Early-Stage Bi-Weekly Alendronate to Improve Bone Mineral Density and Bone Turnover in Chinese Post-Menopausal Women at Risk of OsteoporosisTai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trialZoledronic Acid for the Prevention of Bone Loss in Postmenopausal Women With Low Bone MassIs the NHANES III Femoral Neck Database Discordant With the Total Hip and Trochanteric Region Databases?Efficacy and safety of monthly oral ibandronate in the prevention of postmenopausal bone lossSiete preguntas sobre la osteopeniaVertebral Fracture Assessment by Dual-Energy X-ray Absorptiometry: Insurance Coverage Issues in the United States A White Paper of the International Society for Clinical DensitometryClinical and basic research papers – May 2005 selections 3 May 2005Volume 142, Issue 9Page: 796-7KeywordsBoneBone densityDrugsGlucocorticoid therapyOsteopeniaOsteoporosisRadiologistsSpineTreatment guidelines ePublished: 3 May 2005 Issue Published: 3 May 2005 CopyrightCopyright © 2005 by American College of Physicians. 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