Essential Osteoporosis Management for the Primary Care Provider

Authors

  • David Kendler, MD University of British Columbia, Vancouver, B.C.

DOI:

https://doi.org/10.58931/cpct.2024.2228

Abstract

Most individuals will experience deterioration in bone with advancing age, with consequent increases in fragility fractures. In addition, falls become more frequent with age, further increasing fracture risk. It is important to note that osteoporotic fractures impair quality of life and lead to increased dependency to a much greater degree in elderly individuals. Because of menopause-related declines in estrogen, women have greater bone loss and increases in fragility fracture compared to men. Our increased understanding of osteoporosis, its epidemiology, fracture risk, and expanding management options provide excellent opportunities for clinicians to benefit patients and maintain quality of life in aging individuals.

Author Biography

David Kendler, MD, University of British Columbia, Vancouver, B.C.

Dr. Kendler graduated from the MD program at the University of Toronto in 1977. After completing a rotating internship in Toronto, he practiced for several years in Canada, Botswana, and New Zealand. He returned to Internal Medicine training in 1983 in Christchurch, New Zealand and in 1984 joined the Internal Medicine program in Halifax, Canada. In 1985 he moved to Vancouver to complete Internal Medicine and Endocrinology training at the University of British Columbia. After a 2-year thyroid immunology Fellowship in New York, he returned to the University of British Columbia Faculty of Medicine where he is now a Professor of Medicine in Endocrinology. He has led osteoporosis programs at Children and Women’s Hospital and St. Paul’s Hospital. He is the director of Prohealth Clinical Research, a major North American centre for clinical trials in the area of osteoporosis. He serves on the Scientific Advisory Council of Osteoporosis Canada and Chairs the Western Osteoporosis Alliance. He is a Past-President of the International Society for Clinical Densitometry. He is a member of the Committee of Scientific Advisors of the International Osteoporosis Foundation and is co-Chair of the Western Osteoporosis Alliance. He has been awarded the John Bilezekian ISCD Global Leadership Award and the IOF President’s award. He has served on the Board of Directors of the Canadian Menopause Society. He has published over 140 peer-reviewed papers on osteoporosis therapies, osteoporosis risk assessment, and autoimmune thyroid disease.  

References

Danazumi MS, Lightbody N, Dermody G. Online effectiveness of fracture liaison service in reducing the risk of secondary fragility fractures in adults aged 50 and older: a systematic review and meta-analysis. Osteoporos Int. 2024 Mar 27. DOI: https://doi.org/10.1007/s00198-024-07052-1

Ross AC, Manson JE, Abrams SA, et al. The 2011 Report on dietary reference intakes for calcium and vitamin d from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011 Jan; 96(1): 53-8. DOI: https://doi.org/10.1016/j.jada.2011.01.004

https://osteoporosis.ca/exercise-recommendations/.

Adachi JD, Brown JP, Schemitsch E, et al. Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world perspective database study in Ontario, Canada. BMC Muscoloskelet Disord. 2021 Feb 26;22(1):224. DOI: https://doi.org/10.1186/s12891-021-04051-9

Real-world retrospective database study in Ontario, Canada. BMC Musculoskelet Disord. 2021;22:224.

Balasubramanian A, Zhang J, Chen L, et al. Risk of subsequent fracture after prior fracture among older women. Osteoporos Int. 2019;30:79-92. DOI: https://doi.org/10.1007/s00198-018-4732-1

Johansson H, Siggeirsdottir K, Harvey NC, et al. Imminent risk of fracture after fracture. Osteoporos Int. 2017;28:775-80. DOI: https://doi.org/10.1007/s00198-016-3868-0

https://www.fraxplus.org/

Camacho PM. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis—2020 Update. Endocrine Practice. 2020 May;26(Suppl 1):1-46. DOI: https://doi.org/10.4158/GL-2020-0524SUPPL

Kendler DL, Cosman F, Stad RK, et al. Denosumab in the treatment of osteoporosis: 10 years later: a narrative review. Adv Ther. 2022;39:58-74. DOI: https://doi.org/10.1007/s12325-021-01936-y

Cosman F, Kendler DL, Langdahl BL, et al. Romosozumab and antiresorptive treatment: the importance of treatment sequence. Osteoporos Int. 2022;33:1243-56. DOI: https://doi.org/10.1007/s00198-021-06174-0

Adler RA et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research. 2016;31(1):16–35. DOI: https://doi.org/10.1002/jbmr.2708

Black DM, Geiger EJ, Eastell R, et al. Atypical femur fracture risk versus fragility fracture prevention with bisphosphonates. N Engl J Med. 2020;383:743-53). DOI: https://doi.org/10.1056/NEJMoa1916525

Brankin E, Mitchell C, Monroe R & on behalf of Lanarkshire Osteoporosis Service. Curr Med Res Opin. 2005;21:4:475-82. DOI: https://doi.org/10.1185/030079905X38150

https://www.asbmr.org/about/news-release-detail/press-release-asbmr-coalition-clinical-recommendat.

Published

2024-09-09

How to Cite

1.
Kendler D. Essential Osteoporosis Management for the Primary Care Provider. Can Prim Care Today [Internet]. 2024 Sep. 9 [cited 2024 Oct. 16];2(2):4–8. Available from: https://canadianprimarycaretoday.com/article/view/2-2-kendler

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Section

Articles