Clinical challenges in the management of osteoporosis

Sheryl F Vondracek1, Paul Minne2, Michael T McDermott31Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA; 2Amgen Medical Affairs, Denver, CO, USA; 3Director of the Endocrine and Diabetes Practice, Department of Medicine, University of Color...

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Autores principales:	Sheryl F Vondracek, Paul Minne, Michael T McDermott
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/454f0996718f4dfe975e19c7a13da0c9
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spelling	oai:doaj.org-article:454f0996718f4dfe975e19c7a13da0c92021-12-02T00:31:10ZClinical challenges in the management of osteoporosis1178-1998https://doaj.org/article/454f0996718f4dfe975e19c7a13da0c92008-06-01T00:00:00Zhttps://www.dovepress.com/clinical-challenges-in-the-management-of-osteoporosis-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Sheryl F Vondracek1, Paul Minne2, Michael T McDermott31Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA; 2Amgen Medical Affairs, Denver, CO, USA; 3Director of the Endocrine and Diabetes Practice, Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver, CO, USAAbstract: While knowledge regarding the diagnosis and treatment of osteoporosis has expanded dramatically over the last few years, gaps in knowledge still exist with guidance lacking on the appropriate management of several common clinical scenarios. This article uses fictional clinical scenarios to help answer three challenging questions commonly encountered in clinical practice. The first clinical challenge is when to initiate drug therapy in a patient with low bone density. It is estimated that 34 million Americans have low bone density and are at a higher risk for low trauma fractures. Limitations of using bone mineral density alone for drug therapy decisions, absolute risk assessment and evidence for the cost-effectiveness of therapy in this population are presented. The second clinical challenge is the prevention and treatment of vitamin D deficiency. Appropriate definitions for vitamin D insufficiency and deficiency, the populations at risk for low vitamin, potential consequences of low vitamin D, and how to manage a patient with low vitamin D are reviewed. The third clinical challenge is how to manage a patient receiving drug therapy for osteoporosis who has been deemed a potential treatment failure. How to define treatment failure, common causes of treatment failure, and the approach to the management of a patient who is not responding to appropriate osteoporosis therapy are discussed.Keywords: osteoporosis, osteopenia, bisphosphonate, vitamin D, dual-energy X-ray absorptiometrySheryl F VondracekPaul MinneMichael T McDermottDove Medical PressarticleGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 3, Pp 315-329 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Geriatrics RC952-954.6
spellingShingle	Geriatrics RC952-954.6 Sheryl F Vondracek Paul Minne Michael T McDermott Clinical challenges in the management of osteoporosis
description	Sheryl F Vondracek1, Paul Minne2, Michael T McDermott31Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA; 2Amgen Medical Affairs, Denver, CO, USA; 3Director of the Endocrine and Diabetes Practice, Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver, CO, USAAbstract: While knowledge regarding the diagnosis and treatment of osteoporosis has expanded dramatically over the last few years, gaps in knowledge still exist with guidance lacking on the appropriate management of several common clinical scenarios. This article uses fictional clinical scenarios to help answer three challenging questions commonly encountered in clinical practice. The first clinical challenge is when to initiate drug therapy in a patient with low bone density. It is estimated that 34 million Americans have low bone density and are at a higher risk for low trauma fractures. Limitations of using bone mineral density alone for drug therapy decisions, absolute risk assessment and evidence for the cost-effectiveness of therapy in this population are presented. The second clinical challenge is the prevention and treatment of vitamin D deficiency. Appropriate definitions for vitamin D insufficiency and deficiency, the populations at risk for low vitamin, potential consequences of low vitamin D, and how to manage a patient with low vitamin D are reviewed. The third clinical challenge is how to manage a patient receiving drug therapy for osteoporosis who has been deemed a potential treatment failure. How to define treatment failure, common causes of treatment failure, and the approach to the management of a patient who is not responding to appropriate osteoporosis therapy are discussed.Keywords: osteoporosis, osteopenia, bisphosphonate, vitamin D, dual-energy X-ray absorptiometry
format	article
author	Sheryl F Vondracek Paul Minne Michael T McDermott
author_facet	Sheryl F Vondracek Paul Minne Michael T McDermott
author_sort	Sheryl F Vondracek
title	Clinical challenges in the management of osteoporosis
title_short	Clinical challenges in the management of osteoporosis
title_full	Clinical challenges in the management of osteoporosis
title_fullStr	Clinical challenges in the management of osteoporosis
title_full_unstemmed	Clinical challenges in the management of osteoporosis
title_sort	clinical challenges in the management of osteoporosis
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/454f0996718f4dfe975e19c7a13da0c9
work_keys_str_mv	AT sherylfvondracek clinicalchallengesinthemanagementofosteoporosis AT paulminne clinicalchallengesinthemanagementofosteoporosis AT michaeltmcdermott clinicalchallengesinthemanagementofosteoporosis
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Clinical challenges in the management of osteoporosis

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