Living Medical Textbook - Osteoporosis - Projects In Knowledge - Fracture Prevention and Therapeutic Management Edition Table of Contents

Living Medical
Textbook
From Projects In Knowledge

Osteoporosis

Fracture Prevention and Therapeutic Management Edition

Table of Contents | CME/CE Information | Technical Requirements | Login

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Chapter 1
Overview of Osteoporosis
Last Reviewed: May 20, 2010

Chapter 2
Identifying Patients at Risk for Osteoporosis and Fractures
Last Reviewed: May 20, 2010

Chapter 3
Assessment of Fracture Risk Using FRAX^®
Last Reviewed: May 20, 2010

Chapter 4
Treatment of Osteoporosis
Last Reviewed: May 20, 2010

Chapter 5
Management of the Postfracture Patient
Last Reviewed: May 20, 2010

Chapter 6
Monitoring
Last Reviewed: May 20, 2010

–	Rationale for Monitoring
–	Monitoring Therapy with Serial Bone Mineral Density Testing
–	Interpreting Response and Subsequent Disease Management
–	Role of Bone Turnover Markers in Monitoring Therapy
–	Conclusion
–	References

This activity is supported by an educational donation provided by Amgen.

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This CME program will include a brief pretest. Please start now by answering these 4 questions:

Which of the following results suggests an acceptable response to an oral bisphosphonate for the treatment of osteoporosis?

	2% increase in femoral neck T-score compared with baseline
	2% decrease in distal 1/3 radius T-score compared with baseline
	A change in lumbar spine BMD compared with baseline that is less than the “least significant change” (LSC)
	A decrease in lumbar spine BMD compared with baseline that is greater than the LSC

Prior to start of therapy, Mrs. E had a baseline spine BMD test done by central DXA. She has just completed 2 years of treatment with an oral bisphosphonate. You tell her it is time to check her response and recommend:

	Central DXA BMD of the lumbar spine or hip at any testing location convenient for her
	Central DXA BMD of the lumbar spine at any testing location convenient for her
	Central DXA BMD of the lumbar spine at the same testing location where the baseline test was done
	Quantitative ultrasound of the calcaneus at the same testing location where the baseline test was done

Patients with an acceptable response to therapy:

	Should never have another BMD test
	Can be monitored thereafter using FRAX
	Should have annual measurement of a bone turnover marker thereafter
	Should be considered for periodic monitoring with BMD testing

Currently, how often do you use each of the following clinical practice strategies?

	Always	Very Often	Sometimes	Not Very Often	Never	N/A
Monitor response to osteoporosis pharmacologic therapy with bone mineral density (BMD) testing 1 to 2 years after start of therapy
Monitor response to osteoporosis pharmacologic therapy with BMD testing by DXA of the lumbar spine
Monitor response to osteoporosis pharmacologic therapy with BMD testing by DXA of the hip
Evaluate the BMD change from baseline by comparing it to the calculated “least significant change” (LSC)
Evaluate adherence in patients with decreased BMD at follow-up
Evaluate for secondary risk factors in patients with decreased BMD at follow-up