The National Osteoporosis Foundation (NOF) sets guidelines for treatment of osteoporosis in the United States based on expert consensus. The latest guidelines were published in 2008. These are released in conjunction with the World Health Organization release of new osteoporosis assessment report and fracture risk assessment tool.
Treatment guidelines were established based on fracture risk and a cost-effective model for lowering risk with use of osteoporosis medicines. The guidelines for treatment are for postmenopausal women of any race or ethnicity and men age 50 and over.
Three major categories are defined as high-risk groups that should consider treatment with FDA-approved medicines to lower their risk:
- Fracture of the hip or spine
- Bone mineral density in the osteoporosis range (T-score of -2.5 or lower)
- Bone mineral density in the low bone mass or osteopenia range with a higher risk of fracture defined by FRAX score for
- Major osteoporotic fracture 10-year probability of 20% or higher OR
- Hip fracture 10-year probability 3% or higher