pmc0372351596Ann Intern MedAnn Intern MedAnnals of internal medicine0003-48191539-3704398998551319705110.7326/ANNALS-24-03547HHSPA2169869ArticlePharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians (Version 1: Update Alert 1: Surveillance Note 1)QaseemAmirMD, PhD, MHAAmerican College of Physicians, Philadelphia, PennsylvaniaCooneyThomas G.MDOregon Health & Science University, Portland, OregonShamliyanTatyana A.MD, MSAmerican College of Physicians, Philadelphia, PennsylvaniaYostJenniferPhD, RNAmerican College of Physicians, Philadelphia, and Villanova University, Villanova, PennsylvaniaHicksLauri A.DOCenters for Disease Control and Prevention, Atlanta, Georgiathe Clinical Guidelines Committee of the American College of Physicians*

This article, authored by Amir Qaseem, MD, PhD, MHA; Thomas G. Cooney, MD; Tatyana A. Shamliyan, MD, MS; Jennifer Yost, PhD, RN; and Lauri A. Hicks, DO was developed for the Clinical Guidelines Committee of the American College of Physicians. Members of the Clinical Guidelines Committee who served as authors were Lauri A. Hicks, DO (Vice Chair); Ethan M. Balk, MD, MPH; Thomas G. Cooney, MD; J. Thomas Cross, Jr., MD, MPH; Nick Fitterman, MD; Johanna Lewis, PhD (nonphysician public member); Amy M. Linsky, MD, MSc; Michael Maroto, JD, MBA (nonphysician public member); Matthew C. Miller, MD; Adam J. Obley, MD; Douglas K. Owens, MD, MS; Paul G. Shekelle, MD, PhD, MPH; and Jeffrey A. Tice, MD. Authors from ACP were Itziar Etxeandia-Ikobaltzeta, PharmD, PhD; Amir Qaseem, MD, PhD, MHA; Tatyana A. Shamliyan, MD, MS; and Jennifer Yost, PhD, RN. Approved by the ACP Board of Regents on 18 November 2024.

Corresponding Author: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; aqaseem@acponline.org.85202632025042202522520261783e2403547e2403547

This Surveillance Note 1 alerts readers that a search for new studies was done for the American College of Physicians (ACP) living clinical guideline on “Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults” (version 1) (1, 2). The ACP Center for Evidence Reviews at the Portland Veteran Affairs Research Foundation identified no new studies that met inclusion criteria from this surveillance search period between 29 September 2023 (last search date for the Update Alert of version 1 of the living systematic review) to 25 July 2024 (3, 4). The next surveillance is planned for 6 months.

The ACP Clinical Guidelines Committee made a decision that an update of the living systematic review is not warranted at this time because of a lack of any conclusionchanging evidence on benefits or harms from surveillance searches (2). The ACP reaffirms the recommendations in the living clinical guideline on pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults (version 1) (1, 2).

Acknowledgment:

Members of the ACP Clinical Guidelines Committee who participated in the development of this project but did not vote or author: Carolyn J. Crandall, MD, MS, Chair. ACP staff who participated in the development of this project but did not vote or author: Kate Carroll, MPH, and Curtis S. Harrod, PhD, MPH.

Financial Support:

Financial support for the development of this guideline comes exclusively from the ACP operating budget.

Disclaimer:

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Clinical guidelines are meant to guide care based on the best available evidence and may not apply to all patients or individual clinical situations. They should not be used as a replacement for a clinician’s judgment. Any reference to a product or process contained in a guideline is not intended as an endorsement of any specific commercial product. All ACP clinical guidelines are considered automatically withdrawn or invalid 5 years after publication, or once an update has been issued.

Disclosures: All financial and intellectual disclosures of interest were declared, and potential conflicts were discussed and managed. Dr. Crandall was recused from authorship and voting due to moderate-level conflicts (recently authored relevant publications). A record of disclosures of interest and management of conflicts is kept for each Clinical Guidelines Committee meeting and conference call and can be viewed at www.acponline.org/clinical_information/guidelines/guidelines/conflicts_cgc.htm. Disclosure forms are available with the article online.

ReferencesQaseemA, HicksLA, Etxeandia-IkobaltzetaI, ; Clinical Guidelines Committee of the American College of Physicians. Pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults: a living clinical guideline from the American College of Physicians. Ann Intern Med. 2023;176:224–238. doi:10.7326/M22-103436592456 QaseemA, HicksLA, Etxeandia-IkobaltzetaI, ; Clinical Guidelines Committee of the American College of Physicians. Pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults: a living clinical guideline from the American College of Physicians (version 1, update alert). Ann Intern Med. 2024;177:eL230113. doi:10.7326/L24-011338710077 AyersC, KansagaraD, LazurB, Effectiveness and safety of treatments to prevent fractures in people with low bone mass or primary osteoporosis: a living systematic review and network meta-analysis for the American College of Physicians. Ann Intern Med. 2023;176:182–195. doi:10.7326/M22-068436592455 AyersC, WardR, KansagaraD. Update alert: effectiveness and safety of treatments to prevent fractures in people with low bone mass or primary osteoporosis: a living systematic review and network meta-analysis for the American College of Physicians. Ann Intern Med. 2024;177:eL230118. doi:10.7326/L24-011838710084