- Current Osteoporosis Reports
Author: E. Michael Lewiecki
Publisher: Springer US
Purpose of Review
Treat-to-target (goal-directed therapy) has been proposed as a strategy to assist clinicians in selecting the most appropriate initial treatment for osteoporosis and guiding subsequent decisions to continue, change, or stop treatment. This is a review of the current medical evidence regarding treatment targets and potential clinical applications in managing patients with osteoporosis.
Analyses of randomized placebo-controlled trials of approved agents to treat osteoporosis have generally shown that larger increases in bone mineral density are associated with greater reduction in fracture risk. Achievement of T-scores > −2.5 to −2.0 with treatment appears to provide little additional fracture protection.
The paradigm of treat-to-target is aimed at enhancing and individualizing the care of patients with osteoporosis. Based on the best available data, the most promising target is T-score > −2.5. More data are needed to validate the clinical utility of treat-to-target for osteoporosis.