Endocrine Society Updates Osteoporosis Clinical Practice Guideline

New recommendations include romosozumab therapy for high risk patients

The Endocrine Society today announced an update to its osteoporosis Clinical Practice Guideline to include recommendations for romosozumab, a new medication that was approved last year to treat postmenopausal women at high risk of fracture.

The U.S. Food and Drug Administration approved romosozumab in April 2019, a month after the guideline was published.

“We felt it was important to update our guideline to reflect the newest, most effective medication options available for patients with osteoporosis,” says Clifford J. Rosen, MD, director of the Center for Clinical and Translational Research at the Maine Medical Center Research Institute in Scarborough. Rosen chaired the writing committee that developed the guideline.

“Romosozumab offers promising results for postmenopausal women with severe osteoporosis or who have a history of fractures,” Rosen says. “It does, however, come with a risk of heart disease, so clinicians need to be careful when selecting patients for this therapy.”

New recommendations from the guideline include:

  • Postmenopausal women who have a very high risk of fracture can be treated with romosozumab for up to one year, but women with a high risk of heart disease and stroke should not be considered for treatment with romosozumab, pending further studies.
  • Women who have been on romosozumab for a year should be treated with antiresorptive osteoporosis therapies to protect their bone health.

“Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Guideline Update,” was published in the Society’s Journal of Clinical Endocrinology & Metabolism, online ahead of print.