TY - JOUR
T1 - Repeating Measurement of Bone Mineral Density when Monitoring with Dual-energy X-ray Absorptiometry
T2 - 2019 ISCD Official Position
AU - Kendler, David L.
AU - Compston, Juliet
AU - Carey, John J.
AU - Wu, Chih Hsing
AU - Ibrahim, Ammar
AU - Lewiecki, E. Michael
N1 - Funding Information:
DK has received consultant honoraria, speaker honoraria, and/or research grants from Eli Lilly, Amgen, AstraZenica, and Pfizer.
Funding Information:
JJC has received speaker honoraria for Amgen, Eli Lilly and Pfizer Ireland, Pfizer Canada and Brazil and U.C.B. Ireland. He has also received travel grants from Amgen, MSD and Abbvie Ireland and Research Grants from Abbvie Ireland, Amgen Europe and MSD Ireland. He has served on scientific advisory boards for U.C.B. Europe, Hospira U.K., Europe and Canada, and Pfizer U.K.
Publisher Copyright:
© 2019 The International Society for Clinical Densitometry
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Bone mineral density (BMD) can be measured at multiple skeletal sites using various technologies to aid clinical decision-making in bone and mineral disorders. BMD by dual-energy X-ray absorptiometry (DXA) has a critical role in predicting risk of fracture, diagnosis of osteoporosis, and monitoring patients. In clinical practice, DXA remains the most available and best validated tool for monitoring patients. A quality baseline DXA scan is essential for comparison with all subsequent scans. Monitoring patients with serial measurements requires technical expertise and knowledge of the least significant change in order to determine when follow-up scans should be repeated. Prior ISCD Official Positions have clarified how and when repeat DXA is useful as well as the interpretation of results. The 2019 ISCD Official Positions considered new evidence and clarifies if and when BMD should be repeated. There is good evidence showing that repeat BMD measurement can identify people who experience bone loss, which is an independent predictor of fracture risk. There is good evidence showing that the reduction in spine and hip fractures with osteoporosis medication is proportional to the change in BMD with treatment. There is evidence that measuring BMD is useful following discontinuation of osteoporosis treatment. There is less documentation addressing the effectiveness of monitoring BMD to improve medication adherence, whether monitoring of BMD reduces the risk of fracture, or effectively discriminates patients who should and should not recommence treatment following an interruption of medication. Further research is needed in all of these areas.
AB - Bone mineral density (BMD) can be measured at multiple skeletal sites using various technologies to aid clinical decision-making in bone and mineral disorders. BMD by dual-energy X-ray absorptiometry (DXA) has a critical role in predicting risk of fracture, diagnosis of osteoporosis, and monitoring patients. In clinical practice, DXA remains the most available and best validated tool for monitoring patients. A quality baseline DXA scan is essential for comparison with all subsequent scans. Monitoring patients with serial measurements requires technical expertise and knowledge of the least significant change in order to determine when follow-up scans should be repeated. Prior ISCD Official Positions have clarified how and when repeat DXA is useful as well as the interpretation of results. The 2019 ISCD Official Positions considered new evidence and clarifies if and when BMD should be repeated. There is good evidence showing that repeat BMD measurement can identify people who experience bone loss, which is an independent predictor of fracture risk. There is good evidence showing that the reduction in spine and hip fractures with osteoporosis medication is proportional to the change in BMD with treatment. There is evidence that measuring BMD is useful following discontinuation of osteoporosis treatment. There is less documentation addressing the effectiveness of monitoring BMD to improve medication adherence, whether monitoring of BMD reduces the risk of fracture, or effectively discriminates patients who should and should not recommence treatment following an interruption of medication. Further research is needed in all of these areas.
UR - http://www.scopus.com/inward/record.url?scp=85075543712&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075543712&partnerID=8YFLogxK
U2 - 10.1016/j.jocd.2019.07.010
DO - 10.1016/j.jocd.2019.07.010
M3 - Review article
C2 - 31378452
AN - SCOPUS:85075543712
VL - 22
SP - 489
EP - 500
JO - Journal of Clinical Densitometry
JF - Journal of Clinical Densitometry
SN - 1094-6950
IS - 4
ER -