#ACR22 #Osteoporosis Guidelines Case Example:
The FRAX score needs to be adjusted (multiply by 1.15 or 1.2) in pts who are expected to have cumulative dose >5 grams/year of steroids @rheumnow https://t.co/wF8LP0iZjw
14M111 Updated ACR Guidelines for Glucocorticoid-Induced Osteoporosis #ACR22 🦴🦴
Initial Fracture Risk Assessment - by age - remember: no FRAX scores <40 yo
Fracture re-assessments every 1-2 years with repeat BMD and risk stratifications
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
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
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
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
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
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
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
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
#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
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
At my COVID home command center, I feel pretty prepared for everything. From here, I can run my practice, manage and home-school 3 children and keep the family afloat.
I have 2 computers: one for telemedicine/business meetings and one for e-learning lessons/school updates that teachers and school administrators email me throughout the day for my children. As a no-nonsense, organized mom and doctor, I felt ready to handle any issues that would arise. Read Post