Treat to Target has been standard for chronic diseases like high blood pressure and diabetes for decades. These are chronic diseases, more common as we get older, that we can control with diet, exercise, and eventually medication. We cannot cure them.
Bone health joins the Treat to Target club in 2017. Increased Fracture Risk (Clinical Osteoporosis) is a chronic disease, more common as we get older, that we can control with diet, exercise, and eventually medication. We cannot cure Increased Fracture Risk, so treatment of some sort is necessary “forever”.
What is our target? Traditionally it has been maintaining the T-score found at the first assessment. This does not necessarily make sense, especially if there already are fractures. The target should be NO NEW FRACTURES. This is a game changer.
This means that we are aiming for a Bone Mineral Density T-score higher than -2.5 in someone who has not yet fractured. How we get there requires a new approach to medications, once we have reached the limits of Take Control Naturally detailed in previous posts.
This also means we need to check the VFA for previous Vertebral Compression Fractures, most of which go un-noticed, mistaken for pulled muscles. (I did that a few years back.)
THE TARGET IS NO NEW FRACTURES.
Jay Ginther, MD
University of Wisconsin hosts biennially the Bare Bones of Osteoporosis Care Symposium. This year the Wisconsin Bone Club followed the symposium.
Felicia Cosman, MD from Helen Hayes in New York was the guest speaker at both. She expanded on the new thoughts and guidelines presented at NOF in April. These were a complete change of approach from just a few years ago.
Treat to Target. Anabolics first to build bone and then preserve with Antiresorptives. Reconsider VFA for all first time DXA evaluations.
More detail about these in the weeks to come.
Jay Ginther, MD
As we enter Memorial Day Weekend, let us remember those who have served in times of war, declared and undeclared.
Evil exists in our world. Those who survived the fight against the insanity of Hitler and the Holocaust are literally dying out. We have not adequately honored them or those involved in more recent conflicts.
Peace and safety for ourselves and others in the world unfortunately requires sacrifices by our military veterans. Some die, some are maimed physically or mentally, all are permanently changed.
We should thank them.
We can at least remember them.
Jay Ginther., MD
The second meeting of the Iowa Bone Club was a great success. Hats off to Dudley Phipps, PA, of Iowa Ortho for organizing a great meeting, and to his staff for the work necessary to make it happen. Thanks to Lilly for assisting in bringing Robert Lindsey, MD, from Helen Hayes Osteoporosis Research Center to be our featured speaker. Thanks to Amgen and Radius for their support as well.
We had over two dozen bone health providers and staff gathered in Des Moines yesterday. We came from Burlington, Cedar Rapids and Waterloo in the east, from Spirit Lake and Omaha in the west, and many from the center of the state. Eight outstanding speakers!
We will be meeting in Cedar Rapids in the fall, and Spirit Lake next spring, dates to be announced.
Jay Ginther, MD
President, Iowa Bone Club