Literature

Curbside Consults Podcast

Published September 19, 2019

Osteoporosis affects more than 10 million people living in the United States. Although a number of medications are available for treatment of osteoporosis, it remains undertreated. In this episode of Curbside Consults, Dr. Clifford J. Rosen, Professor of Medicine at Tufts University School of Medicine and Associate Editor at the NEJM, joins us to discuss screening and treatment options for osteoporosis.

00:00 – Introduction
1:15 – Screening for osteoporosis
4:96 – When to consider treatment for low bone mineral density
7:16 – Calcium and vitamin D supplementation
8:90 – Vitamin D and its effect on chronic illness
10:35 – Bisphosphonates - First line treatment for osteoporosis
12:83 – Adverse risks with use of bisphosphonates
18:07 – Monitoring of response to treatment
19:91 – When should you not consider a drug holiday?
21:22 – What is considered treatment failure?
24:99 – What is sclerostin?
26:31 – Findings of the ARCH trial
32:98 – Takeaways
34:00 – Conclusion

Resources and articles discussed in this episode:

1. Saag KG et al. Romosozumab or Alendronate for Fracture Prevention in Women with Osteoporosis. N Engl J Med 2019
2. Black DM. Postmenopausal Osteoporosis. N Engl J Med 2016

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

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Dr. Clifford J. Rosen, Professor of Medicine at Tufts University School of Medicine and Associate Editor at the NEJM
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Dr. Amanda Fernandes is an Assistant Professor of Medicine, Endocrinology at The Warren Alpert Medical School of Brown University. She was a 2018-2019 NEJM editorial fellow. She completed her fellowship in Endocrinology at the University of Vermont.