Kristine E. Ensrud, MD, MPH; Carolyn J. Crandall, MD, MS
CME Objective: To review current evidence for screening, prevention, diagnosis, treatment for fracture prevention, and practice improvement of osteoporosis.
Funding Source: American College of Physicians.
Acknowledgment: The authors thank E. Michael Lewiecki, author of the previous version of this In the Clinic.
With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.
In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.
Disclosures: Dr. Ensrud, ACP Contributing Author, reports personal fees from from Merck Sharpe & Dohme, outside the submitted work; Dr. Crandall, ACP Contributing Author, has disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1218.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Osteoporosis is a common systemic skeletal disorder resulting in bone fragility and increased fracture risk. However, management of osteoporosis and fracture prevention strategies are often not addressed by primary care clinicians, even in older patients with recent fractures. Evidence-based screening strategies will improve identification of patients who are most likely to benefit from drug treatment to prevent fracture. In addition, careful consideration of when pharmacotherapy should be started and choice of medication and duration of treatment will maximize the benefits of fracture prevention while minimizing potential harms of long-term drug exposure.
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Ensrud KE, Crandall CJ. Osteoporosis. Ann Intern Med. 2017;167:ITC17–ITC32. doi: 10.7326/AITC201708010
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Published: Ann Intern Med. 2017;167(3):ITC17-ITC32.
Endocrine and Metabolism, Metabolic Bone Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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