New clinical practice guideline released for osteoporosis management in men

The Endocrine Society has released new clinical practice guidelines for the management of osteoporosis in men.

The new guidelines, published in the Journal of Clinical Endocrinology and Metabolism, include focus on men with low vitamin D levels and a pharmacological treatment regimen for men aged 50 years or older with a history of spine or hip fracture.

“For men age 50, one in five will experience an osteoporosis-related fracture in their lifetime,” Nelson Watts, MD, chair of the task force that authored the clinical practice guidelines, stated in an Endocrine Society release. “Mortality after fracture is higher in men than in women. Of the 10 million Americans with osteoporosis, 2 million are men. Of the 2 million fractures due to osteoporosis that occur each year, 600,000 are in men.”

Recommendations from the clinical practice guidelines include:

Men at a higher risk for osteoporosis, including those 70 years of age or older and those between the ages of 50 years and 69 years who display risk factors, should be tested with dual-energy X-ray absorptiometry (DXA);
Men with low vitamin D levels — defined as less than 30 ng/mL — should receive vitamin D supplementation to achieve levels of at least 30 ng/mL;
Pharmacologic treatment should be given to men 50 years of age or older who have had spine or hip fractures, as well as men at high risk of fracture based on low bone mineral density (BMD) and/or clinical risk factors;
Clinicians should monitor BMD by DXA at the spine and hip every 1 year to 2 years; and
Men at risk for osteoporosis should consume 1,000 mg to 1,200 mg of calcium daily. This should come from dietary sources, with calcium supplements added if the diet proves insufficient.

Reference:

Watts NB, Adler RA, Bilezikian JP. Osteoporosis in men: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012. doi: 10.1210/jc.2011-3045