Responding to NEJM Study, Experts Emphasize DXA Scans Needed for Women at Risk for Fractures

Endocrine Society issues statement recommending that timing of bone mineral density testing be individualized

Chevy Chase, MD -- The Endocrine Society released today a statement emphasizing that the ideal timing of repeat BMD testing should be individualized based on the patient’s likelihood to lose bone mass over time. The statement was written in response to a recent study published in the New England Journal of Medicine (NEJM) that suggests that some older women may not need frequent bone density tests if they have normal or slightly diminished bone mineral density (BMD).
 

The NEJM study by Margaret Gourlay et al (N Engl J Med 2012; 366:225-233) examined 4,957 women aged 67 years or older with normal or slightly diminished BMD and no history of hip or clinical vertebral fracture or of treatment for osteoporosis, prospectively for 15 years. During the 15 year follow-up period, less than one percent of women with normal BMD at baseline developed osteoporosis. The authors concluded that women 67 years of age or older with a baseline normal BMD, as determined by a dual x-ray absorptiometry (DXA) test, could safely defer a repeat DXA test for 15 years.
 

The findings of the study do not apply to women 67 years of age or older who have osteoporosis, a history of hip fracture, or to those women who are currently taking osteoporosis medications. The Society advises against a “one size fits all” approach regarding the frequency of BMD testing and encourages patients to talk with their physicians about their BMD measurements and their risk factors for osteoporosis and determine the appropriate time for a DXA test.
 

“The Endocrine Society recommends that all women receive a baseline BMD test at 65 years of age and advises that the timing of repeat DXA testing should be individualized,” said Janet E. Hall, MD, president of The Endocrine Society.  “DXA testing should be done more frequently for those patients with low BMD or those likely to lose bone rapidly over time and less so for those with normal or near-normal BMD and who are otherwise healthy.”
 

Most women who should have already had their first DXA test have not done so, according to the Society’s statement. The Centers for Medicare and Medicaid Services covers DXA testing at a 2-year interval, though there are clearly individuals who should be screened more frequently such as those with moderate or advanced osteopenia and those who have just started or changed osteoporosis therapy.
 

The Society’s full statement can be accessed at: http://www.endo-society.org/advocacy/legislative/letters/upload/Endocrine-Society-Response-to-BMD-Testing-Final.pdf.

Founded in 1916, The Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 15,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society and the field of endocrinology, visit our site at www.endo-society.org. Follow us on Twitter at https://twitter.com/#!/EndoMedia.

Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 15,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.