Osteoporosis - Related Resources

Cochrane reviews

For improving the use of bone mineral density test ordering in osteoporosis, most professional interventions may result in a modest improvement. The effect seems to be larger if a patient mediated or reminder component is part of the intervention Improving Appropriate Imaging in Osteoporosis.
There is insufficient evidence for routine use of bisphosphonate therapy in children with secondary osteoporosis in clinical care Bisphosphonate Therapy for Children and Adolescents with Secondary Osteoporosis.
Calcitonin appears to prevent the decline of bone mass at the lumbar spine but not at the femoral neck. Efficacy for fracture prevention remains to be established Calcitonin for Corticosteroid-Induced Osteoporosis.

Other evidence summaries

Oral anticoagulant treatment may be associated with slight decrease in bone density in ultra distal radius, but there is no evidence of significant decrease at other sites Changes of Bone Density after Exposure to Oral Anticoagulants.
It is not possible to predict an individual's fracture risk from the assessment of serum and urine biochemical markers of bone turnover Biochemical Markers for the Diagnosis of Osteoporosis.
Physical activity (both present and past) may consistently reduce the risk of hip fracture Physical Activity and Predisposition to Hip Fractures.
Bone mineral density may decline rapidly after discontinuation of hormone replacement therapy, but not below the level in the placebo group .
For many women, discontinuation of alendronate after 5 years for up to 5 more years appears not to increase fracture risk, but women at high risk of clinical vertebral fractures (such as those with vertebral fractures or very low BMD) may benefit by continuing beyond 5 years Effects of Continuing or Stopping Alendronate after 5 Years of Treatment.

Clinical guidelines

Management of osteoporosis. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2003:71 http://www.sign.ac.uk/guidelines/fulltext/71/
Management of osteoporosis. Southfield (MI): Michigan Quality Improvement Consortium; 2006 (pdf sheet) http://www.mqic.org/pdf/osteopor06.pdf

Other Internet resources

Osteoporosis management: The online series. AMA Continuing Medical Education Program for Primary Care Physicians. American Medical Association 2004 http://www.ama-cmeonline.com/osteo_mgmt/module04/index.htm
Osteoporosis - Prevention, diagnosis and treatment. Systematic literature review. SBU Report 165/1+2. SBU - The Swedish Council on Technology Assessment in Health Care, 2003 http://www.sbu.se/en/Published/Yellow/Osteoporosis---prevention-diagnosis-and-treatment/
Osteoporosis in Postmenopausal Women: Diagnosis and Monitoring. Evidence Report/Technology Assessment No. 28. Agency for Healthcare Research and Quality (AHRQ) Publication No. 01-E032 http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1.chapter.39885#top
Wells GA, Cranney A, Boucher M, Peterson J, Shea B, Robinson V, Coyle D, Tugwell P. Biphosphonates for the primary and secondary prevention of osteoporotic fractures in postmenopausal women: a meta-analysis. Technology report no 69. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006 http://www.cadth.ca/index.php/en/hta/reports-publications/search/publication/659 [Tiivistelmä suomeksi]
Stevenson M, Davis S, Lloyd-Jones M, Beverley C. The clinical effectiveness and cost-effectiveness of strontium ranelate for the prevention of osteoporotic fragility fractures in postmenopausal women. Health Technol Assess 2007;11(4) http://www.ncchta.org/execsumm/summ1104.htm [Tiivistelmä suomeksi]
Stevenson M, Lloyd Jones M, De Nigris E, Brewwer N, Davis S, Oakley J. A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess 2005;9(22) http://www.ncchta.org/execsumm/summ922.htm [Tiivistelmä suomeksi]

Literature

Kanis JA, McCloskey EV, Johansson H et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013;24(1):23-57. [PubMed]
Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet 2011;377(9773):1276-87. [PubMed]
Lekamwasam S, Adachi JD, Agnusdei D et al. A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 2012;23(9):2257-76. [PubMed]
Lekamwasam S, Adachi JD, Agnusdei D et al. A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 2012;23(9):2257-76. [PubMed]
Laliberté MC, Perreault S, Jouini G et al. Effectiveness of interventions to improve the detection and treatment of osteoporosis in primary care settings: a systematic review and meta-analysis. Osteoporos Int 2011;22(11):2743-68. [PubMed]
Ebeling P. Osteoporosis in men. N Engl J Med 2008;358:1474-1482
Reginster JY, Adami S, Lakatos P, Greenwald M, Stepan JJ, Silverman SL, Christiansen C, Rowell L, Mairon N, Bonvoisin B, Drezner MK, Emkey R, Felsenberg D, Cooper C, Delmas PD, Miller PD. Efficacy and tolerability of once-monthly oral ibandronate in postmenopausal osteoporosis: 2 year results from the MOBILE study. Ann Rheum Dis 2006 May;65(5):654-61. [PubMed]
Kannus P, Parkkari J, Niemi S, Pasanen M, Palvanen M, Järvinen M, Vuori I. Prevention of hip fracture in elderly people with use of hip protector. N Engl J Med 2000;343:1506-13
De Groen PC, Lubbe DF, Hirsch, LJ, et al. Esophagitis associated with the use of alendronate. N Engl J Med 1996;335:1016-21
Raisz LG. Screening for osteoporosis. [Clinical practice] N Engl J Med 2005;353:164-71
Michaelsson K, Baron JA, Farahmand BY, et al. Hormone replacement therapy and risk of hip fracture: population based case-control study. BMJ 1998;316:1858-63
Stevenson JC, Cust MP, Gnagar KT. Effects of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in postmenopausal women. Lancet 1990;335:265-9
Cauley JAQ, Seeley DG, Ensrud K, Ettinger V, Black D, Cummings SR. Estrogen replacement therapy and fractures in older women. Ann Intern Med 1995;122:9-16
Cummings SR, Eckert S, Krueger KA, Grady D, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. JAMA 1999;281:2189-2197
Delmas PD, Bjarnason NH, Mitlak BH, et al. Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in post-menopausal women. N Engl J Med 1997;337:1641-7
Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G. Effect of vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997;337:670-6
McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY; Hip Intervention Program Study Group. Effect of risedronate on the risk of hip fracture in elderly women. N Engl J Med 2001;344:333-340
Adachi JD, Bensen WG, Brown J, et al. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med 1997;337:382-7
Harris ST, Watts NB, Jackson RD, et al. Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med 1993;95:557-67
Pols HA, Felsenberg D, Hanley DA, Stepan J, Munoz-Torres M, Wil TJ, Qin-Sheng G, Galich AM, Vandormael K, Yates AJ, Stych B. Multinational, placebo-controlled, randomized trial of the effect of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study. Osteoporos Int 1999;9:461-468
Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures-results from the fracture intervention trial. JAMA 1998;280:2077-82
Black DM, Cummings SR, Karpf DB, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 1996;348:1535-41
Liberman UA, Weiss SR, Bröll J, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 1995;333:1437-43
Devine A, Dick IM, Heal SJ, Criddle RA, Prince RL. A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporosis Int 1997;23-8
Dawson-Hughes, Dallal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990;323:878-83
Khosla S, Melton LJ. Osteopenia. N Engl J Med 2007;356:2293-2300

Primary/Secondary Keywords

Osteoporosis

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References

Osteoporosis - Related Resources

Cochrane reviews

Other evidence summaries

Clinical guidelines

Other Internet resources

Literature