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FOR IMMEDIATE
RELEASE
Contact:
molly@nof.org
(202) 721-6341
NATIONAL OSTEOPOROSIS
FOUNDATION RELEASES NEW CLINICAL
RECOMMENDATIONS FOR LOW BONE MASS AND
OSTEOPOROSIS INCORPORATING ABSOLUTE
FRACTURE RISK
Washington, DC (February 21, 2008) – The
National Osteoporosis Foundation (NOF)
is releasing its new Clinician’s Guide
to Prevention and Treatment of
Osteoporosis representing a major
breakthrough in the way healthcare
providers evaluate and treat people with
low bone mass or osteoporosis and the
risk of fractures. NOF’s new Clinician’s
Guide introduces guidelines beyond
Caucasian postmenopausal women to
include African-American, Asian, Latina
and other postmenopausal women, and
addresses men age 50 and older for the
first time.
Osteoporosis is a major public health
problem that has both a medical and
economic impact in the U.S. Fractures
caused by either osteoporosis or low
bone mass can lead to chronic pain,
disability and even death, as well as
psychological symptoms, including
depression. Each year broken bones due
to low bone mass or osteoporosis cause
over 432,000 hospital admissions, almost
2.5 million medical office visits and
about 180,000 nursing home admissions.
“NOF’s new Clinician’s Guide
dramatically alters the approach to
assessing fracture risk and treatment,”
said Bess Dawson-Hughes, M.D., chair of
the Clinician’s Guide Development
Committee and past president of NOF.
“The Guide provides evidenced-based
recommendations to help healthcare
providers better identify people at high
risk for developing osteoporosis and
fractures and assures that those at
highest risk are recommended for
treatment to lower that risk.”
The new Clinician’s Guide applies the
recently released algorithm on absolute
fracture risk called FRAX® by the World
Health Organization (WHO). FRAX® is also
referred to as a 10-year fracture risk
model and 10-year fracture probability.
This algorithm estimates the likelihood
of a person to break a bone due to low
bone mass or osteoporosis over a period
of 10 years.
Absolute fracture risk methodology
provides a markedly improved method to
assure that people with the highest
fracture risk get treated. Those at
highest risk include postmenopausal
women and older men with a diagnosis of
osteoporosis, based on a BMD test
T-score of -2.5 or lower, or those with
a clinical diagnosis based on having
sustained a hip or spine fracture. In
addition, absolute fracture risk
calculations help to resolve many of the
questions about management for people
with low bone mass, also called
osteopenia. These are people with a
T-score between -1.0 and -2.5 on their
bone mineral density (BMD) test.
The WHO algorithm takes into account not
only bone mineral density (BMD) at the
hip but also nine specific clinical risk
factors for osteoporosis and related
fractures. NOF has adapted this
algorithm for the U.S. and incorporates
not only fracture outcome and mortality
data from U.S. women and men, but also
cost effectiveness analysis to determine
when it is cost effective to treat a
person with an osteoporosis medication
to prevent a fracture.
“In developing the new Clinician’s
Guide, NOF is providing healthcare
professionals in the U.S. with the
newest advances for diagnosing and
managing osteoporosis,” said Ethel
Siris, M.D., president of the National
Osteoporosis Foundation. “To be able to
better identify and treat those patients
at risk for osteoporosis and costly
fractures will have a positive impact on
the medical, emotional and economic
burden that osteoporosis bears on this
country.”
In the near future, some central DXA
(dual-energy x-ray absorptiometry)
machines that test the bone mineral
density of the hip and spine should be
able to provide a report that gives
information on a person’s absolute
fracture risk by incorporating the NOF
application of the WHO algorithm into
the bone density machine’s computer.
Alternatively, clinicians can also enter
a patient’s bone mineral density hip
T-score and other risk factor
information in a simple web-based
version of the algorithm in the doctor’s
office to obtain absolute fracture risk
in seconds. The information about
absolute fracture risk will help both
healthcare providers and patients decide
whether treatment with an osteoporosis
medication is needed.
The new Clinician’s Guide also provides
recommendations for clinicians on when
to do bone mineral density testing,
clinical evaluation, risk factors for
falls and universal recommendations for
the prevention of osteoporosis. NOF
summarizes the universal recommendations
in its 5 Steps to Bone Health. These 5
Steps advise people to:
1. Get the daily recommended amounts of
calcium and vitamin D.
2. Engage in regular weight-bearing and
muscle-strengthening exercise.
3. Avoid smoking and excessive alcohol.
4. Talk to your healthcare provider
about bone health.
5. Have a bone density test and take
medication when appropriate.
The new Clinician’s Guide recommends
that adults over age 50 get 1,200 mg of
calcium and 800-1,000 IU of vitamin D3
daily. Vitamin D3 is the form of vitamin
D that best supports bone health. It is
also called cholecalciferol.
The Clinician’s Guide was developed by
an expert committee of NOF in
collaboration with a multi-specialty
council of medical experts in the field
of bone health convened by NOF. The
Clinician’s Guide provides
recommendations that are intended to
serve as a reference for clinical
decision making with individual
patients. The recommendations are not
intended to be rigid standards, limits
or rules and should not be interpreted
as quality standards. Earlier versions
of the updated Clinician’s Guide to
Prevention and Treatment of Osteoporosis
were called the Physician’s Guide to
Prevention and Treatment of
Osteoporosis.
Established in 1984, the National
Osteoporosis Foundation is the nation’s
leading voluntary health organization
solely dedicated to osteoporosis and
bone health. Our mission is to prevent
osteoporosis, to promote lifelong bone
health, to help improve the lives of
those affected by osteoporosis and
related fractures, and to find a cure.
For more information on osteoporosis and
bone health, contact NOF online at
www.nof.org or by telephone (800)
223-9994.
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