There is no consensus on the optimal frequency of monitoring and preferred site to monitor (UpToDate – Guidelines for monitoring response to therapy)

• Recommendations range from against monitoring (American College of Physicians) to every one to two years
• Don’t routinely repeat DXA scans more often than once every two years – ChoosingWisely (American College of Rheumatology)

Bone density changes slowly and the magnitude of change over a shorter durations may be due to measurement error
Thus, bone density should be checked when the results influence clinical management or at the point of a significant expected change in bone mineral density.

Our expert opinion recommendation is to recheck BMD in:

• 1-2 years on zoledronic acid
  • You could consider erring on the shorter range for certain high risk conditions, such as glucocorticoid use.
• 2 years for all other bisphosphonates