Estimates of the Proportion of Older White Women Who Would Be Recommended for Pharmacologic Treatment by the New U.S. National Osteoporosis Foundation Guidelines

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Abstract
The new U.S. National Osteoporosis Foundation Clinician's Guide to Prevention and Treatment of Osteoporosis includes criteria for recommending pharmacologic treatment based on history of hip or vertebral fracture, femoral neck (FN), or spine BMD T-scores ≤−2.5 and presence of low bone mass at the FN or spine plus a 10-yr risk of hip fracture ≥3% or of major osteoporotic fracture ≥20%. The proportion of women who would be recommended for treatment by these guidelines is not known. We applied the NOF criteria for treatment to women participating in the Study of Osteoporotic Fractures (SOF). To determine how the SOF population differs from the general U.S. population of white women ≥65 yr of age, we compared women in SOF with women who participated in the National Health and Nutrition Examination Survey (NHANES) III on criteria included in the NOF treatment guidelines that were common to both cohorts. Compared with NHANES III, women in SOF had higher FN BMD and were younger. Application of NOF guidelines to SOF data estimated that at least 72% of U.S. white women ≥65 yr of age and 93% of those ≥75 yr of age would be recommended for drug treatment. Application of the new NOF Guidelines would result in recommending a very large proportion of white women in the United States for pharmacologic treatment of osteoporosis.