Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline

TLDR

The guideline aims to provide evidence‑based recommendations for pharmacologic treatment of osteoporosis in postmenopausal women. The committee reviewed clinical trial data, clinical experience, patient preferences, adherence, persistence, and risk‑benefit profiles, and incorporated country‑specific fracture risk assessment tools into the guideline development. The guideline recommends four key principles: country‑specific fracture risk assessment, inclusion of patient preferences, concurrent nutritional and lifestyle interventions with fall prevention, and the use of multiple pharmacologic therapies to reduce fracture risk.

Abstract

The objective is to formulate clinical practice guidelines for the pharmacological management of osteoporosis in postmenopausal women.Evidence from clinical trials and insights from clinical experience with pharmacologic therapies for osteoporosis were critically evaluated in formulating this guideline for the management of postmenopausal osteoporosis. Patient preferences, data on adherence and persistence, and risks and benefits from the patient and provider perspectives were also considered in writing committee deliberations. A consensus by the Writing Committee members was achieved for four management principles: (i) The risk of future fractures in postmenopausal women should be determined using country-specific assessment tools to guide decision-making. (ii) Patient preferences should be incorporated into treatment planning. (iii) Nutritional and lifestyle interventions and fall prevention should accompany all pharmacologic regimens to reduce fracture risk. (iv) Multiple pharmacologic therapies are capable of reducing fracture rates in postmenopausal women at risk with acceptable risk-benefit and safety profiles.