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Dr. B Humphrey #ACR22 #Osteoporosis Guidelines:
in patients under 40 yo, you cannot calculate #FRAX score, assess BMD and in children get also thoracolumbar xrays. Get repeat testing every 1-2 years #ACR22 @rheumnow https://t.co/CgsvzGKYuV
TheDaoIndex KDAO2011 ( View Tweet)
14M111 Updated ACR Guidelines for Glucocorticoid-Induced Osteoporosis #ACR22 🦴🦴
Reminder: Recalculate FRAX scores with scaling for prednisone equivalent dosing!
Use other clinical fracture risk assessments
@RheumNow https://t.co/qZDlb1Cij7
Eric Dein ericdeinmd ( View Tweet)
Staggering stats after a #osteoporosis hip fracture!
40% cannot walk independently
30% have a permanent disability
20% mortality in surgically fixed hip
40% mortality if not surgically fixed. -Dr. M Humphrey #ACR22 @rheumnow https://t.co/DSYQjDw6pW
TheDaoIndex KDAO2011 ( View Tweet)
ATOM study, Abs 1314, greater proportion of men with OP on abaloparatide vs placebo met the definition of a >3% responder at the LS, TH, and FN. #ACR22 @RheumNow https://t.co/q6gcX5Azts https://t.co/WEjqbl14ZN
Dr. Rachel Tate uptoTate ( View Tweet)
Benefits with receiving anabolic agents upfront before antiresoprtives (as opposed to other way around). Shame about lack of access to this sequence currently
@RheumNow #ACR22 #osteoporosis https://t.co/S2ttbrVaab
Julian Segan JulianSegan ( View Tweet)
Romo works even better in higher risk patients. More ammunition to use up-front. Availability is a limiting factor though.
@RheumNow #ACR22 #osteoporosis https://t.co/90X97jVJcP
Julian Segan JulianSegan ( View Tweet)
Emphasis that drug holiday is NOT drug retirement in osteoporosis. Ideal time to re-initiate is quite uncertain however. Continue to monitor DEXA and fracture risk factors.
@RheumNow #ACR22 #osteoporosis https://t.co/iLKrxdzpAR
Julian Segan JulianSegan ( View Tweet)
Atypical femoral fracture risk increases over time. Risk decreases slowly as well with time off treatment. Absolute risk remains relatively low however.
@RheumNow #ACR22 #osteoporosis https://t.co/pcIfhRW4WJ
Julian Segan JulianSegan ( View Tweet)
Good BMD gains in switching BP->denosumab, especially in first few years. #sequentialtherapy
@RheumNow #ACR22 #osteoporosis https://t.co/t1hItKn8sB
Julian Segan JulianSegan ( View Tweet)
Osteoporotic fx in AS
Abstract #0388 #ACR22 @RheumNow
🦴2k adults in RISE, mean age 68y, 44% female, 76% white
🦴Higher risk with: older age, increased comorbidity index, OP history, chronic use of opioids, low BMI
🦴Men and women were equally likely to fracture
Catherine Sims, MD DrCassySims ( View Tweet)
Limited utility for using bone turnover markers in osteoporosis. Perhaps useful to assess adherence to oral therapy.
@RheumNow #ACR22 #osteoporosis https://t.co/g6f7SnOzNR
Julian Segan JulianSegan ( View Tweet)
Ab0575 #ACR22 MI/CVA in Osteoporosis Pts on DEN/ ZOL, L Spangler
DEN pts more likely CKD, adjusted analysis
At 36 mos, risk for Den vs Zol in 2 database claims:
- MI: 0.97, 1.22 (0.8-1.7)
- CVA: 0.9 (0.6-1.2), 1.0
No incr. risk identified with Den vs Zol in MI or CVA
@RheumNow https://t.co/hgyG1ZmFLT
Eric Dein ericdeinmd ( View Tweet)
Ab0574 #ACR22: Osteoporosis in Men - Under-recognized? Under-Screened? Under-Diagnosed!
@AMollaeianMD: Retrosp study >65 yo
<1% M have DEXA compared to 7-10% in F in 2010, 2018, and 2021
Hip fx 4.1% F, 3% M
DEXA declined in M between 2010-2018, no change in 2021
🦴🦴🩻
@RheumNow https://t.co/LbmxLnIX1Q
Eric Dein ericdeinmd ( View Tweet)
Which one to use for prevention and which for treatment? Drugs covered by #Medicare based on indication #osteoporosis #acr22 #acrreview @RheumNow https://t.co/KE5F6Sn3wg
TheDaoIndex KDAO2011 ( View Tweet)
#osteoporosis baseline lab work should be completed to assess for secondary causes. DEXA is underutilized in men and should be considered especially in men with inflammatory disease
Baseline labs: CBC, BMP, PTH, vit D, TSH, urine ca, testosterone #ACR22 @RheumNow https://t.co/byXLQFpe3n
Catherine Sims, MD DrCassySims ( View Tweet)
Medicare will cover #DXA testing for these diagnoses @RheumNow #acr22 #acrreview https://t.co/keZg0fxyz9
TheDaoIndex KDAO2011 ( View Tweet)
Did You Know? FDA relaxed warnings on #sarcoma with #Forteo- can use more than 2 years @RheumNow #acr22 #acrreview #osteoporosis https://t.co/Xzr6TZIlWN
TheDaoIndex KDAO2011 ( View Tweet)
Drug holidays for #osteoporosis RX but be note fracture risk may increase with these holidays- consider an anabolic agent during these times - Dr Tanner #acr22 @RheumNow #acrreview https://t.co/6XbpYD5D1X
TheDaoIndex KDAO2011 ( View Tweet)
Dr Tanner presents the features of AFF👇
It is rare, subtrochanteric in location and often appears w/n 5-10 yrs of BP use.
#ACR22 @RheumNow #acrreview #osteoporosis https://t.co/KbMJ4dXfpj
sheila RHEUMarampa ( View Tweet)
P1NP is a useful bone turnover marker that Dr. Tanner checks to monitor #osteoporosis therapy (if insurance covers it) - it is not affected by diurnal variation, food, renal function. #ACR22 @rheumnow #ACRReview
TheDaoIndex KDAO2011 ( View Tweet)