Review of the guideline of the American College of Physicians on the treatment of osteoporosis
This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, summarizes several failings of the recent guidelines of the American College of Physicians (ACP) on the treatment of low bone density or osteoporosis to prevent fractures.
The ACP recently issued guidelines for the treatment of low bone density or osteoporosis to prevent fractures.
Literature review and critical review of the ACP guidelines.
The guideline is lacking in scope due to the endorsement of treatment based on T-scores rather than fracture risk assessment and in failure to adequately consider anabolic therapies.
The ACP guideline appears outdated.
KeywordsBone mineral density Fracture risk FRAX Intervention thresholds Treatment guidelines
We are grateful to the Committee of Scientific Advisors and the Committee of National Societies of the International Osteoporosis Foundation (IOF) and the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) for their reviews and endorsement of this manuscript.
Compliance with ethical standards
Conflicts of interest
JAK reports grants from Amgen, Eli Lilly, and Radius Health; non-financial support from Medimaps and Asahi; and other support from AgNovos. JAK is the architect of FRAX but has no financial interest. Professor Cooper reports personal fees from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda, and UCB. RR has received consulting fees or advisory board fees from Radius Health, Labatec, Danone, and Nestlé. J-YR has received advisory board or speaker fees from Asahi-Kasei, Eli Lilly, IBSA-Genévrier, Nycomed-Takeda, PharmEvo, Radius Health, Roche, Servier, UCB, Will Pharma, and Zodiac.
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