Osteoporosis: Very High Risk – “Osteoporosis with high-risk features”

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Osteoporosis: Very High Risk – “Osteoporosis with high-risk features”

geriguidesNovember 1, 2021List of Guides 0

Patients with multiple osteoporotic fractures* and osteoporotic BMD score (T < 2.5) have a very high risk of recurrent fracture

*While osteoporotic fractures are generally those that would have not occurred in a young and healthy individual, major osteoporotic fractures are typically those of the hip, spine, forearm, and proximal humerus (though definitions vary).

The benefits of antiresorptive/anabolic osteoporosis therapy strongly outweigh the risk (PLACEHOLDER).

These very high risk patients should be strongly considered for anabolic therapy, such as teriparatide/abaloparatide or romosozumab

Very high-risk patients should be considered for anabolic therapy, such as teriparatide/abaloparatide or romosuzumab, although the antiresoprtives (bisphosphonates and denosumab) are also considered first line.

  • The anabolic agents are very potent but are expensive and require more monitoring for side effects.
  • Endocrine consultation is recommended