Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |6 June 2017

Treatment of Low Bone Density or Osteoporosis to Prevent Fracture Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 9 May 2017.
  • The full report is titled “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.” The authors are A. Qaseem, M.A. Forciea, R.M. McLean, and T.D. Denberg, for the Clinical Guidelines Committee of the American College of Physicians.


Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
×
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
  • FULL ARTICLE
    • What is low bone density and osteoporosis?
    • How did the American College of Physicians (ACP) develop these guidelines?
    • What does ACP recommend that patients and doctors do?
    • Questions for my doctor
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link
  • CiteULike Link

What is low bone density and osteoporosis?

Osteoporosis is a disease that causes bone loss, which leads to weakened bones and makes it easier for them to break or have fractures. You may be at higher risk for osteoporosis if you:
• Are a woman older than 65.
• Are a man older than 70.
• Are not active. People who are not active move very little. For example, they rarely walk, climb stairs, do housework, or garden.
• Have a low body weight.
• Are a current smoker.
• Drink more than 3 alcoholic drinks per day.
• Have low vitamin D or calcium levels.
Your doctor can check your bone density using a test called dual-energy absorptiometry, or a DXA scan. This test takes pictures of your bones. You do not need this scan until you are older than 65.
If your DXA results are below a certain number, your doctor may diagnose you with osteoporosis and you may need treatment.
It is possible to have weakened bones but not osteoporosis. This is called low bone density and may also require treatment. Sometimes low bone density is called osteopenia.

How did the American College of Physicians (ACP) develop these guidelines?

The authors looked at studies related to the treatment of low bone density and osteoporosis in men and women. They then chose the best treatment options based on the results of the studies. The best treatment options were shown to prevent broken bones.

What does ACP recommend that patients and doctors do?

Doctors should prescribe bisphosphonates to women with osteoporosis. These medicines can include alendronate, risedronate, zoledronic acid, or denosumab.
Doctors should also prescribe bisphosphonates to men with osteoporosis.
Doctors should treat patients with osteoporosis for 5 years. During this time, additional DXA scans are not needed. After 5 years of treatment, DXA scans may be repeated and your treatment may change.
Doctors should not use menopausal estrogen, menopausal estrogen plus progestogen, or raloxifene therapy to treat osteoporosis.
Doctors and patients should discuss the benefits, harms, and costs of all treatment options. Patient preferences and risk for broken bones should also be discussed when considering treatment.

Questions for my doctor

Will my osteoporosis ever go away?
How can I stop my low bone density from becoming osteoporosis?
What happens if I stop taking the medicine?
Should I take calcium or vitamin D supplements?
Can I still do the things I like to do?
Should I make changes to my diet?
Can I still take my other medicines?
What can I do to prevent falls?
What types of side effects does the medicine have?
How much will the medicine cost?
This article was published at Annals.org on 9 May 2017.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Treatment of Low Bone Density or Osteoporosis to Prevent Fracture. Ann Intern Med. ;166:I–24. doi: 10.7326/P17-9038

Download citation file:

  • Ris (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2019

×
Permissions

Published: Ann Intern Med. 2017;166(11):I-24.

DOI: 10.7326/P17-9038

Published at www.annals.org on 9 May 2017

©
2017 American College of Physicians
1 Citations

See Also

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
View MoreView Less

Related Articles

Annals for Educators - 6 June 2017
Annals of Internal Medicine; 166 (11): ED11
Drug Treatment for Low Bone Density or Osteoporosis to Prevent Fractures: A Clinical Practice Guideline from the American College of Physicians
Annals of Internal Medicine; 149 (6): I-46
Cost-Effectiveness of Alendronate in Postmenopausal Women with Low Bone Mass without Osteoporosis or Previous Fracture
Annals of Internal Medicine; 142 (9): I-36
Pharmacologic Treatment of Low Bone Density or Osteoporosis to Prevent Fractures: A Clinical Practice Guideline from the American College of Physicians
Annals of Internal Medicine; 149 (6): 404-415
View MoreView Less

Journal Club

In postmenopausal women with osteoporosis, romosozumab followed by alendronate reduced fractures vs alendronate alone
Annals of Internal Medicine; 168 (2): JC3
Review: Osteoporosis drugs may improve BMD and reduce fractures in some patients with CKD
Annals of Internal Medicine; 167 (4): JC19
Review: Teriparatide reduces fractures in postmenopausal women with osteoporosis
Annals of Internal Medicine; 157 (6): JC3-4
Tibolone reduced risk for fractures and breast cancer but increased risk for stroke in older women with osteoporosis
Annals of Internal Medicine; 149 (10): JC5-8
View MoreView Less

Related Point of Care

Osteoporosis
Annals of Internal Medicine; 167 (3): ITC17-ITC32
Osteoporosis
Annals of Internal Medicine; 155 (1): ITC1-1
Hip Fracture
Annals of Internal Medicine; 155 (11): ITC6-1
View MoreView Less

Related Topics

Endocrine and Metabolism
Metabolic Bone Disorders

Endocrine and Metabolism, Metabolic Bone Disorders.

PubMed Articles

RAGE Signaling in Skeletal Biology.
Curr Osteoporos Rep 2019.
Glucocorticoid-Induced Osteoporosis: New Insights into the Pathophysiology and Treatments.
Curr Osteoporos Rep 2019.
View More

Results provided by: PubMed

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Latest RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards and Cover

  • Personae (Cover Photo)
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×