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New ISCD Guidelines related with TBS

A task force was formed to review new medical evidence about the use of TBS for monitoring treatment with approved osteoporosis drugs.

Short summary:

  • While, as expected, we should not expect much improvement of trabecular structure under antiresorptive therapy, “TBS is potentially useful for monitoring anabolic therapy”.
  • “A statistically significant increase in TBS in a treated patient may represent clinically meaningful improvement in trabecular structure”. Conversely, “a statistically significant decrease of TBS in a treated or untreated patient may represent a clinically worsening of trabecular structure and increase fracture risk”, “suggesting the need for further clinical assessment and possible change in treatment strategies.”
  • “BMD measures bone quantity and TBS measures bone quality. These tests can be considered complementary in assessing fracture risk and response to therapy in appropriately selected patients”.

The experts have also recommended the use of TBS in combination with the BMD for orthopedic and spine surgery patients with diabetes mellitus (long term duration of diabetes (>10yrs) and poor control).

See ISCD official position:

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