Q&A: Clifford Rosen, MD: Practice Guideline on Pharmacological Treatment of Osteoporosis in Post-Menopausal Women

Clifford Rosen

Endocrine News talks with Clifford Rosen, MD, chair of the task force that created the latest Endocrine Society Clinical Practice Guideline on Pharmacological Management of Osteoporosis in Post-Menopausal Women.

In March, the Endocrine Society issued a Clinical Practice Guideline on treating post-menopausal women with osteoporosis. Titled “Pharmacological Management of Osteoporosis in Post-Menopausal Women: An Endocrine Society Clinical Practice Guideline.” The guideline was published online and will appear in the May 2019 print issue of The Journal of Clinical Endocrinology & Metabolism.

Clifford Rosen, MD, director, Center for Clinical and Translational Research at the Maine Medical Center Research Institute in Scarborough, is the chair of the guideline writing committee that authored this guideline. He shared his thoughts with Endocrine News about how he hopes this guideline will improve patient care as well as patients’ confidence in the treatment they receive as well as how this guideline improves on other guidelines on this topic.

“It is our firm belief that the knowledge gained from reading these guidelines will not only improve patient care but provide confidence in treatment.”

Endocrine News: What was the main reason for the publication of the osteoporosis in postmenopausal women guideline – what drove the decision and why now?

Clifford Rosen: There is a considerable gap in the treatment of osteoporosis. Most women will not take anti-osteoporosis therapies despite their efficacy, and those that do often stop. Hence the rate of hip fractures has leveled off and may actually be increasing. In addition, bone density screening has declined precipitously. These changes are likely due to the perceived risks versus benefits of treating osteoporosis.

EN: What are your hopes for the impact of the guideline on endocrine standards of care for postmenopausal women with osteoporosis? 

CR: By pointing out the therapeutic efficacy, we hope that more providers will engage their patients in shared decision making. It is essential that endocrinologists in particular will be active participants in this process since most of the osteoporosis treatment approaches have been directed at endocrinologists. Notwithstanding, it is our firm belief that the knowledge gained from reading these guidelines will not only improve patient care but provide confidence in treatment.

EN: How do you expect other medical specialties to be affected by the Guideline Writing Committee’s recommendations?

CR: We think others will embrace clear guidelines for diagnosing and treating osteoporosis. Of course, there are other guidelines and recommendations, but [the new Endocrine Society guidelines] are free of conflict, purely evidence based, and the result of three years of work to define the optimal approaches to osteoporosis therapy.

“We acknowledge that patient care is not an exact science, and these recommendations do not fit every individual but rather provide a framework for care.”

EN: What are the key take-home messages for patients in this guideline?

CR: The current treatments are effective, and the risk benefit often falls towards a significant benefit rather than harm. But once again it is important to note that efforts to engage patients in their treatments require time, knowledge and patience. We acknowledge that patient care is not an exact science, and these recommendations do not fit every individual but rather provide a framework for care.

 

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