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Osteopenia: To Treat or Not To Treat?

Michael R. McClung, MD
[+] Article, Author, and Disclosure Information

From Providence Portland Medical Center, Oregon Osteoporosis Center, Portland, OR 97213.

Potential Financial Conflicts of Interest: 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).

Requests for Single Reprints: Michael R. McClung, MD, Oregon Osteoporosis Center, 5050 NE Hoyt, Suite 651, Portland, OR 97213; e-mail, mmcclung@orost.com.

Ann Intern Med. 2005;142(9):796-7. doi:10.7326/0003-4819-142-9-200505030-00018
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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 osteoporosis, drug therapy reduces the incidence of important fragility fractures (3), and the cost-effectiveness of treating these women has been demonstrated (47). As a result, treating postmenopausal women who have osteoporosis is not controversial.

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