title: Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians.
abstract: METHODS
  The American College of Physicians (ACP) developed this guideline to present the available evidence on various pharmacologic treatments to prevent fractures in men and women with low bone density or osteoporosis.
  
  
  METHODS
  Published literature on this topic was identified by using MEDLINE (1966 to December 2006), the ACP Journal Club database, the Cochrane Central Register of Controlled Trials (no date limits), the Cochrane Database of Systematic Reviews (no date limits), Web sites of the United Kingdom National Institute of Health and Clinical Excellence (no date limits), and the United Kingdom Health Technology Assessment Program (January 1998 to December 2006). Searches were limited to English-language publications and human studies. Keywords for search included terms for osteoporosis, osteopenia, low bone density, and the drugs listed in the key questions. This guideline grades the evidence and recommendations according to the ACP's clinical practice guidelines grading system. RECOMMENDATION 1: ACP recommends that clinicians offer pharmacologic treatment to men and women who have known osteoporosis and to those who have experienced fragility fractures (Grade: strong recommendation; high-quality evidence). RECOMMENDATION 2: ACP recommends that clinicians consider pharmacologic treatment for men and women who are at risk for developing osteoporosis (Grade: weak recommendation; moderate-quality evidence). RECOMMENDATION 3: ACP recommends that clinicians choose among pharmacologic treatment options for osteoporosis in men and women on the basis of an assessment of risk and benefits in individual patients (Grade: strong recommendation; moderate-quality evidence). RECOMMENDATION 4: ACP recommends further research to evaluate treatment of osteoporosis in men and women.
authors.affiliation: American College of Physicians, Philadelphia, Pennsylvania 19106, USA. aqaseem@acponline.org
authors.forename: Amir
authors.initials: A
authors.lastname: Qaseem
authors.forename: Vincenza
authors.initials: V
authors.lastname: Snow
authors.forename: Paul
authors.initials: P
authors.lastname: Shekelle
authors.forename: Robert
authors.initials: R
authors.lastname: Hopkins
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Forciea
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Owens
mesh_terms: D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy*; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy*; D012307:Risk Factors; D014481:United States
chemical_list: D050071:Bone Density Conservation Agents