Goal-Directed Treatment for Osteoporosis: A Progress Report From the ASBMR-NOF Working Group on Goal-Directed Treatment for Osteoporosis

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dc.contributor.author Cummings, SR en
dc.contributor.author Cosman, F en
dc.contributor.author Lewiecki, EM en
dc.contributor.author Schousboe, JT en
dc.contributor.author Bauer, DC en
dc.contributor.author Black, DM en
dc.contributor.author Brown, TD en
dc.contributor.author Cheung, AM en
dc.contributor.author Cody, K en
dc.contributor.author Cooper, C en
dc.contributor.author Diez-Perez, A en
dc.contributor.author Eastell, R en
dc.contributor.author Hadji, P en
dc.contributor.author Hosoi, T en
dc.contributor.author Jan De Beur, S en
dc.contributor.author Kagan, R en
dc.contributor.author Kiel, DP en
dc.contributor.author Reid, Ian en
dc.contributor.author Solomon, DH en
dc.contributor.author Randall, S en
dc.date.accessioned 2017-05-04T05:01:10Z en
dc.date.issued 2017-01 en
dc.identifier.citation Journal of Bone and Mineral Research 32(1):3-10 Jan 2017 en
dc.identifier.issn 0884-0431 en
dc.identifier.uri http://hdl.handle.net/2292/32771 en
dc.description.abstract The American Society for Bone and Mineral Research and the United States National Osteoporosis Foundation (NOF) formed a working group to develop principles of goal-directed treatment and identify gaps that need to be filled to implement this approach. With goal-directed treatment, a treatment goal would first be established and choice of treatment determined by the probability of achieving that goal. Goals of treatment would be freedom from fracture, a T-score > -2.5, which is above the NOF threshold for initiating treatment, or achievement of an estimated risk level below the threshold for initiating treatment. Progress toward reaching the patient's goal would be periodically and systematically assessed by estimating the patient's compliance with treatment, reviewing fracture history, repeating vertebral imaging when indicated, and repeating measurement of bone mineral density (BMD). Using these data, a decision would be made to stop, continue, or change therapy. Some of these approaches can now be applied to clinical practice. However, the application of goal-directed treatment cannot be fully achieved until medications are available that provide greater increases in BMD and greater reduction in fracture risk than those that are currently approved; only then can patients with very high fracture risk and very low BMD achieve such goals. Furthermore, assessing future fracture risk in patients on treatment requires a new assessment tool that accurately captures the change in fracture risk associated with treatment and should also be sensitive to the importance of recent fractures as predictors of imminent fracture risk. Lastly, evidence is needed to confirm that selecting and switching treatments to achieve goals reduces fracture risk more effectively than current standard care. © 2016 American Society for Bone and Mineral Research. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.publisher American Society for Bone and Mineral Research en
dc.relation.ispartofseries Journal of Bone and Mineral Research en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Goal-Directed Treatment for Osteoporosis: A Progress Report From the ASBMR-NOF Working Group on Goal-Directed Treatment for Osteoporosis en
dc.type Journal Article en
dc.identifier.doi 10.1002/jbmr.3039 en
pubs.issue 1 en
pubs.begin-page 3 en
pubs.volume 32 en
dc.rights.holder Copyright: American Society for Bone and Mineral Research en
dc.identifier.pmid 27864889 en
pubs.end-page 10 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 605532 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Science en
pubs.org-id Science Research en
pubs.org-id Maurice Wilkins Centre (2010-2014) en
dc.identifier.eissn 1523-4681 en
pubs.record-created-at-source-date 2017-05-04 en
pubs.dimensions-id 27864889 en


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