Osteoporosis: High risk – “Osteoporosis”

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Osteoporosis: High risk – “Osteoporosis”

geriguidesNovember 1, 2021List of Guides 0

Patients with prior osteoporotic fracture*, an osteoporotic BMD score (T < 2.5), or with a high clinical risk factor score for fracture in 10 years (FRAX: >3% at hip and >20% any fracture), the risk of fracture is high.

* 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 of therapy. See impact on fractures below (PLACEHOLDER)
We suggest bisphosphonates in a primary care setting due to cost and simplicity.
  • We suggest bisphosphonates in a primary care setting as they are inexpensive, effective and well tolerated, and available in oral formulations (as well as IV infusion).  The other antiresorptive agents also require closer and more frequent lab monitoring
  • However, bisphosphonates, denosumab, teriparatide/abaloparatide, and romosozumab are all considered first line in osteoporosis treatment guidelines