Show simple item record

dc.contributor.authorConley, R.B.
dc.contributor.authorAdib, G.
dc.contributor.authorHochberg, M.C.
dc.date.accessioned2019-12-25T18:07:12Z
dc.date.available2019-12-25T18:07:12Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85076373399&doi=10.1002%2fjbmr.3877&partnerID=40&md5=df070e59c8b36fa8839815edd816c573
dc.identifier.urihttp://hdl.handle.net/10713/11552
dc.description.abstractOsteoporosis-related fractures are undertreated, due in part to misinformation about recommended approaches to patient care and discrepancies among treatment guidelines. To help bridge this gap and improve patient outcomes, the American Society for Bone and Mineral Research assembled a multistakeholder coalition to develop clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture. The coalition developed 13 recommendations (7 primary and 6 secondary) strongly supported by the empirical literature. The coalition recommends increased communication with patients regarding fracture risk, mortality and morbidity outcomes, and fracture risk reduction. Risk assessment (including fall history) should occur at regular intervals with referral to physical and/or occupational therapy as appropriate. Oral, intravenous, and subcutaneous pharmacotherapies are efficacious and can reduce risk of future fracture. Patients need education, however, about the benefits and risks of both treatment and not receiving treatment. Oral bisphosphonates alendronate and risedronate are first-line options and are generally well tolerated; otherwise, intravenous zoledronic acid and subcutaneous denosumab can be considered. Anabolic agents are expensive but may be beneficial for selected patients at high risk. Optimal duration of pharmacotherapy is unknown but because the risk for second fractures is highest in the early post-fracture period, prompt treatment is recommended. Adequate dietary or supplemental vitamin D and calcium intake should be assured. Individuals being treated for osteoporosis should be reevaluated for fracture risk routinely, including via patient education about osteoporosis and fractures and monitoring for adverse treatment effects. Patients should be strongly encouraged to avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies. Finally, referral to endocrinologists or other osteoporosis specialists may be warranted for individuals who experience repeated fracture or bone loss and those with complicating comorbidities (eg, hyperparathyroidism, chronic kidney disease).en_US
dc.description.sponsorshipThis study was funded by Bayer, Gilead Sciences, AbbVie, Amgen and Takeda Pharmaceuticals U.S.A.en_US
dc.description.urihttps://doi.org/10.1002/jbmr.3877en_US
dc.language.isoen_USen_US
dc.publisherJohn Wiley and Sons Inc.en_US
dc.relation.ispartofJournal of Bone and Mineral Research
dc.subjectAgingen_US
dc.subjectAnabolicsen_US
dc.subjectAntiresorptivesen_US
dc.subjectOsteoporosisen_US
dc.subjectSecondary Fracture Preventionen_US
dc.titleSecondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalitionen_US
dc.typeArticleen_US
dc.identifier.doi10.1002/jbmr.3877
dc.identifier.pmid31538675


This item appears in the following Collection(s)

Show simple item record